Quitting Heroin with Suboxone

Hey, new member here but I have often browsed threads in the past on the forum to learn a lot about drugs and addiction. I am hooked on heroin, have been off an on with opiates for 2 years straight after a period in 2007 when I was doing oxy's almost every day (but I didn't really have bad w/d when I quit this). It is worth prefacing as well that I have done some form of narcotic nearly every day since 2006. Whether it be weed, alcohol, ecstasy, LSD, ketamine, adderall, valium, cocaine, or something else I've managed to find drugs have been a regular part of my life. Since this most recent addiction started I have managed to quit cold turkey 3 times, twice from shooting and once from snorting. The w/d was terrible all 3 times, after experiencing it with shooting my first 2 times I planned to never shoot again. I haven't been completely successful here and there have been a couple of times where I've shot with this most recent relapse and addiction, but living with my parents and having my arms exposed in the warm weather has helped as much as the memory of the w/d has at keeping me away from needles.

The present addiction was brought on by my girlfriend. We would do some pills or go down and pick up a bag of heroin most days. This escalated to me developing a dependency that I started to keep from her, she also hid her dependency from me I later would find out. In the middle of 2011 she became terminally ill. Emotionally I was ruined and heroin really helped me get through things. My addiction led me to needles and for about 6 months I was shooting regularly as her health slowly deteriorated. I promised myself I would quit before she died, so I tried to do this in spring of last year. I was clean for a few weeks, but as fate would have it a friend I had lost contact with called me looking for heroin. Mentally I was ready to relapse and so I did exactly this. My girlfriend had lost the ability to walk, her mental capacity had been diminished, and she was visibly only a few months away from dying. Throughout the summer I snorted with the occasional needle, eventually the needles became my main vice, and I quit cold turkey again in October. I was very active at this time so it helped ease the w/d. The first 2 days were hard, but after that I managed to cope as it just felt like a bad cold. I remained sober for about a month. The day before Thanksgiving stress took over and I called my friend and asked for a bag. This relapse has been the worst, I went from spending all my time high to having to conserve my money just to avoid w/d. Where I am now is a state where I am careful with each bag that I get as much out of it as I can and I don't feel sick at any point in time. My girlfriend recently lost her fight with her illness. Despite my sadness over her passing I know that now having the burden of watching her die lifted from my shoulders I can have the strength to get out from under the rock of my heroin addiction.

So, anyway, despite only exclusively snorting now I am on much more than I ever have been before. I average about 1.5 to 2 grams of heroin a day, and I'm mentally not prepared to go through a cold turkey w/d again. The mere thought of how much worse it could be has seen me engage in some addict behavior--selling a lot of my belongings and borrowing cash from friends--to get my next fix. I've had a couple chances to quit during this time. Twice a whole 24 hours has gone by between my last line and finding someone who I can buy from. Each time I thought, just for a second "I'm this far in I can quit... no I'm not doing that." However, I know that now the time is right. I've given you all a bit of my background, now I'm asking for a little bit of encouragement and advice.

I have 8 8mg suboxone films I recently picked up. I wasn't sure if these are enough to quit with, so I haven't started yet. Again, I do anywhere between 1.5g and 2g of heroin every day. I've had a number of recommendations from friends. One said I should use a scale to weigh out heroin, make sure when I do buy it I separate it into 1g bags and that is all I use over the course of a day. I repeat this for 4-5 days. Then I work my way down to .75 and then .5. After this is when he said I should start suboxone at 4mg each, by cutting the strip in half, and taper again every few days. Another told me just to start on 4mg of suboxone 24 hours after my last line and to stay with that dose every time I started to feel w/d symotoms coming on until I go through all of my strips. He claimed quitting would be easy then and the w/d wouldn't be that bad. Another told me to start on with 1 8mg suboxone, let that last as long as possible, go down to 6mg let it last, 4mg let it last, 2mg let it last, and then I'd be done with plenty of leftover suboxone to spare. Do any of these plans have validity? What has been the experience of people here as it relates to tapering with suboxone?

The major point is that I am terrified of another w/d. I don't want it and I know if I experience it I'll call everywhere for suboxone, but if I can't get any in short order I'm fearful of another relapse. Whatever I have to go through I want to make sure it's not a bad w/d.

So thank you for any and all help and support in advance. I'm looking forward to quitting for good. Mentally I've never felt this way about quitting, where it's something I am excited to do and not something I feel as if I need to do. I want to make sure I do it right, as a result I'm not in a rush to start today. The sooner the better though. Again, thank you.

People who do drugs every single day are drug addicts. Suboxone isn't going to change that. Simply withdrawing from heroin with not much pain will never be enough. In my experience with these things, which is ample, you need a program. NA, HA, CA, and AA are free, why don't you try going to a few meetings and see what happens?

Yes, but a Suboxone taper can help make the withdrawal process more bearable and at least reduce that obstacle so that one can work on the mental addiction. Also some meetings don't allow people who are currently using, while some will allow people who are still using to attend as long as you have a desire to quit and aren't noticeably high (nodding out etc) during meetings, so that's something to look into for the groups in one's area.

It's absolutely important to work on the mental addiction and learn how to cope with cravings and the reasons that you use in the first place (anxiety/stress, depression, pain, etc). This can take a number of forms - self-help, therapy, meetings, meditation, etc - and personally I think a multi-pronged approach is best. The physical dependency, while it may feel like the biggest reason you use, obviously isn't or there wouldn't be so many people who go back to using after the withdrawals are over. You need to take an active role in your recovery and have a plan for what to do once your off drugs.

But I think that a Suboxone taper can work well if you are motivated and work on your mental addiction. As for the idea of tapering the heroin, I have never known anyone to very successfully do that, it is extremely difficult to force yourself to do, so I'm not sure about that part. It might be easier to just make the switch to the Suboxone and taper that. I don't think you'll need to start with a full 8mg strip, for the first day I would start with 2mg and then see how you feel a couple hours later and take another 2mg if needed and so on. This will also help reduce the risk of precipitated withdrawal (when you take Suboxone too soon after your last heroin dose it can throw you into peak withdrawal and starting with a lower Sub dose can help somewhat to avoid that). I would recommend gradually reducing the Sub instead of just taking the same dose every day and then stopping abruptly.

Every meeting I've been to will allow intoxicated people as long as they don't share during the meeting. Kicking someone out of a meeting for being intoxicated runs completely contrary to the traditions and the spirit of the big book. We absolutely welcome anyone who has a desire to stop using to attend.

I don't have much of an opinion on suboxone. If it helps someone then that is great. However, I see a lot of chemical management advice going on here and not a lot of sobriety. Just an observation.

I think that what dlinden is proposing is just doing a quick taper using Suboxone to help reduce the withdrawal symptoms, not long-term maintenance. Not that there's anything wrong with long-term maintenance if it improves someone's quality of life (aside from the fact that it sucks to still be physically dependent on something and the maintenance drug [methadone, Suboxone] can be harder to get off than the original drug once you've been on maintenance for a long time).

So lets say dlinden uses suboxone to taper. With out replacing it with some other drug, program, or spiritual practice s/he will go crazy. That is just the nature of addiction imo. I'm not saying we disagree about this. My only point is I see a lot of advice on here that is solely geared towards managing chemical dependency. In reality, chemical dependency is only a surface symptom of a much deeper inability to cope with life.

I know what you mean, but I don't really see that kind of chemical-biased advice given here in the Recovery Forums. Surely you can't think my post sounded like that?

I'm trying to go on a quick taper, yes. The quicker the better. Thank you Swimmingdancer for your help, that certainly seems like the most viable way with which to do it. I'll move over to subs by next weekend, I just want to make sure I'm giving myself a window of a couple of open days (which I'll have starting next weekend) to start this in a relaxing setting.

As for the meeting suggestion, while I understand their benefits I have a psychiatrist I currently see once a week. I've been seeing him for nearly 2 years now and he has worked with me to address the many problems that have been going on in my life the past 2 years. He has suggested me for an outpatient detox program, and that's my next step if the taper doesn't work. Mentally I feel in a much different place because of my time with him and the emotional help he's given me in the face of the truly horrific experience of watching the closest person in my life die over the course of a 2 year illness. He feels that experience is what shaped me the most into needing the escape provided by heroin. This runs contrary to the recreational use I had been doing before. Indeed "nearly every day" was maybe not the best way to word it in my post. I don't have a calendar of how often or not, but if there was a day, or two, or three where I couldn't find weed or (before I was 21) booze it never bothered me. On a handful of weekends my friends and I would seek out something to party with. The last 2 years are a clear, marked change from my life before. This is why now that I have buried my girlfriend he thinks as much as I do that I can get clean and not deal with the threat of relapse. I don't want anyone to think he wasn't encouraging me to quit before she died, he was. I did try, but the stress of daily hospital visits would catch up with me emotionally. He thinks this time my quitting will be completely different as long as I handle it peacefully and avoid stress or anxiety.

So, to summarize, I see a specialist and he hasn't indicated to me that NA is the path I need to go down. He thinks the physical dependency is what I have to get rid of and, now that I'm free from the burden of watching her die, I'm not at a risk to relapse. I hope he's right that the stress of watching her die led me to need an escape that I couldn't find in people and not that my desire to do heroin led me to use her illness as an excuse. I've never been the latter person before in my life, and I don't believe I am now.

Swimmingdancer: I see tons of 'chemical management' device in SL. To be fair there is a good amount of recovery in here as well. I felt like your above post was a mix of both. Please know that I really appreciate you taking the time to help out other suffering addicts

dlinden: I'm sorry that you went through such a big trauma. I truly am.

Everything you have described up to this point is classic addict behavior. You may white knuckle your way out of opiate addiction with the help of suboxone. In my experience it won't be long before an addict is abusing the benzos he inevitably has prescribed for anxiety, smoking tons of weed, and drinking every day. At that point heroin will make a lot of sense and there he goes again. I would absolutely love to be proven wrong but I've listened to hundreds of recovered addicts share their stories and that is how they all go.

What is stopping you from going to one single meeting? Do you think you aren't a real drug addict? You shoot heroin almost every day...normal people don't do that.

It'll be allmost impossible to break the habit without choosing an subsitute which in your case the bupre would be. But you really need to want to stop if your will isnt strong enough you'll probably fail. Just take about 1mg Bupreno per day this will reduce the withdrawal effects to a bearable level. Maybe you are going to need some more Bupre but for me 1mg (nasal) was enough to keep the turkey away a few days. After that you can start to reduce the dose of Bupre you are taking maybe every second day. But as I said i think it is all about mental stuff. if you dont want it enough and if you dont stick to the plans you made for your withdraw it will fail.

dlinden said:

I'm trying to go on a quick taper, yes. The quicker the better. Thank you Swimmingdancer for your help, that certainly seems like the most viable way with which to do it. I'll move over to subs by next weekend, I just want to make sure I'm giving myself a window of a couple of open days (which I'll have starting next weekend) to start this in a relaxing setting.

As for the meeting suggestion, while I understand their benefits I have a psychiatrist I currently see once a week. I've been seeing him for nearly 2 years now and he has worked with me to address the many problems that have been going on in my life the past 2 years. He has suggested me for an outpatient detox program, and that's my next step if the taper doesn't work. Mentally I feel in a much different place because of my time with him and the emotional help he's given me in the face of the truly horrific experience of watching the closest person in my life die over the course of a 2 year illness. He feels that experience is what shaped me the most into needing the escape provided by heroin. This runs contrary to the recreational use I had been doing before. Indeed "nearly every day" was maybe not the best way to word it in my post. I don't have a calendar of how often or not, but if there was a day, or two, or three where I couldn't find weed or (before I was 21) booze it never bothered me. On a handful of weekends my friends and I would seek out something to party with. The last 2 years are a clear, marked change from my life before. This is why now that I have buried my girlfriend he thinks as much as I do that I can get clean and not deal with the threat of relapse. I don't want anyone to think he wasn't encouraging me to quit before she died, he was. I did try, but the stress of daily hospital visits would catch up with me emotionally. He thinks this time my quitting will be completely different as long as I handle it peacefully and avoid stress or anxiety.

So, to summarize, I see a specialist and he hasn't indicated to me that NA is the path I need to go down. He thinks the physical dependency is what I have to get rid of and, now that I'm free from the burden of watching her die, I'm not at a risk to relapse. I hope he's right that the stress of watching her die led me to need an escape that I couldn't find in people and not that my desire to do heroin led me to use her illness as an excuse. I've never been the latter person before in my life, and I don't believe I am now.

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But what happens next time something tragic or stressful happens in your life? Do you have new coping mechanisms to deal with the horrible shit that happens in all of our lives without turning to heroin? I mean, pretty much everyone becomes addicted to heroin because they use it to cope with anxiety, depression, physical pain, or all 3. It becomes our coping mechanism, we have to replace it with healthier coping mechanisms and make major changes in our lives in order to learn how to not go on auto-pilot and walk out the door to score every time we are suffering. Has your psych helped you with this? Psychiatrists can be very different from one another so I don't know what to assume . Some of them just like to medicate everything.

Also Mehm made a good point in that what do you have to lose by going to a meeting? It doesn't have to be NA, there are lots of different types of groups with different philosophies.

Mehm said:

Swimmingdancer: I see tons of 'chemical management' device in SL. To be fair there is a good amount of recovery in here as well. I felt like your above post was a mix of both. Please know that I really appreciate you taking the time to help out other suffering addicts

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Thanks . What I meant was that I rarely see people in the Recovery forums focussing solely on advising people about what drugs to take etc without mentioning the psychological side and the need to make changes in one's life, learn how to cope with cravings, get some kind of help (whatever form that takes) with the mental addiction, etc. People want advice on the physical side of things and I don't think there is anything wrong with that.

You have more than enough suboxone to manage a quick taper, also several ppl have given you legit advice,( 1mg bup, NA, ), however I think the most sound advice I've heard was about your "coping" skills, Yes a quick sub taper will help you avoid most of the physical W/D symptoms, but that's only half the battle. You and a lot of others (myself included) run to their trusty DOC as soon as sorrow and/or adversity comes a knockin'...

We have to invent/find new ways to cope with life's curveballs ( preferably legal ), although getting through acute W/DS and making to the other side is a huge achievement, you're not out of the forest of addiction just yet. In fact using H may be at the back of your mind for the rest of your life, but as long as it's at the back and not the front you'll persevere! As time passes those thoughts will diminish, and will occur less frequent and less potent.

Make an effort to do things that give you pleasure or make you feel good, you may have to concentrate to notice these, as the H has dulled that sense, Listen to a moving song or movie, help others, and reward yourself with chocolate for accomplishing small goals, take it one minute, one temptation at a time. GL on you journey to recovery!

^^^ WTF was I thinking?? Chocolate?? Man life's a bitch! Do what you gotta do to get through it.

The problem with the addiction has been that I was playing around when things got bad with her health. In the past I've had my family, my friends, and others who have been really strong pillars to lean against and so I haven't had the problems with drugs becoming necessary to cope. Heroin wasn't necessary to cope this time, when it became necessary to cope was when I had the physical dependence from playing around with it combine with the emotional trauma. No time became right to quit, and despite trying and coming off it I never really quit because I was still going through this living nightmare. Now that it's over I'm confident that the things there before will be there again--my parents, my close friends, my psych, and during the summer the ability to watch and go to baseball games for one brief example. I do think people are reading too much into my prior recreational drug use. My psychiatrist thinks that it was simple recreational use, my early forays into heroin were this as well. What set off the road to where I am now was the lack of chance to take a step back and stop when I normally would have. In hearing other experiences from people I find a lot of differences in how I handled my life while on heroin compared to theirs. I worked, took care of her, rarely used enough to get high (though the amount I needed increased as it normally does) and only took what I needed not to feel like shit. I was angry at myself for having gotten myself caught up in a situation where I was stuck using a drug. The first time I got clean was great, but the classic old friend dragging me back in happened at the worst time. The second time I got clean was a temporary fix from the start and I knew it. I just wanted to get off needles, and do that I did. Not enough was changing in my life to get me off heroin for good. Now I'm at the point where I can make it work and return to the old me. I've been reassured that this differs from the "typical addict" based on my experiences by my psychiatrist and we have an agreement not to prescribe me any medication--we've had this in place for awhile actually--due to not wanting to develop a physical addiction to benzos based on a prescription. He has obliged fortunately.

I do agree, there is nothing stopping me from going to NA. It's never been something I've been told I need to do, so I haven't made time. One thing that does hold me back is that in this area there are some people I know of very low character who do go to NA meetings more for business connection than actual goodwill. It does nothing to affect my view of the group, but I would hope never to run into these people again and especially at a meeting. I don't want to go into a long background about them, but I did want to let people know that since, yes, there is something holding me back somewhat.

Mehm: I'm not shooting anymore, haven't shot in a long time. Minor semantics, but I wanted to establish that since it makes me worry my posts aren't being read closely enough where I can trust the advice being given.

Anyway tomorrow morning I start doing a little bit of subs to ease the w/d and work my way off. I don't have a date set for being clean, but I have a method and I'm optimistic it won't take me very long. After that it's finally back to normalcy I've been craving for a long, long time.

I hope you find whatever it is you are looking for. Please post back and tell us how its going