Long Term

[joeyfornowya]

I was using Oxy for about two years.

I got off that and was fine except I always felt like I needed to drink alcohol because I wasn't right. It was like my mind could never relax. I think this is because the Oxy rewired my brain after it was in my system for so long. I rarely used Oxy to get high, I would use it to just feel relaxed and was fine with that. I guess we're all different. I was stressed, so that was my way to de-stress.

Now that everything in my life is stable, all good I have been on Suboxone for about 3 years.

I am tapering off, I don't have cravings I just get off of whatever I am using and taking meds doesn't do jack for me. Anti-depressants do not make me feel better. So, I usually start drinking just so I can relax.

I feel like I need to be on Suboxone for the rest of my life just to feel normal and happy. When I take it I am 100% functional as I have ever been. I actually feel great. It's like my own form of an anti-depressant. I do not use it to get high and I have no desire to get "high". I have a desire to be successful, I am driven but I know when I am off suboxone I will feel like I can't relax again, my doctor will give me some shit anti-depressant and I will feel like garbage again.

What can I take or exercise can I do to feel better? My doctors tried every med. for depression but that is not the solution? Will working out and doing a ton of cardio do that trick? Whatever I need to do, I will do it. I just don't know what to do.

 

[Mafioso]

You say you don't have cravings, but you have urges/desire to drink to relax, and wonder if you'll need subs for the rest of your life... Well, by definition, that's what (drug) cravings are- the desire to consume psychoactive substances to alter the way you feel. You probably don't notice these urges as much because you are quenching them before they really become too extreme. Go 12 hours with no subs, alcohol, or any psychoactive substance and I can promise you that your desire to consume a psychoactive substance(cravings) will start to spike until you use again.

There's nothing wrong with that, or at least in the sense that it isn't because you are psychologically weak. Cravings are a physiological phenomenon that occurs after taking addictive drugs.

Take opioids for example. Your body naturally produces chemicals very similar to opioids that work on various opioid receptors in the brain and other parts of the body. The most commonly known is called "endorphin", endo for endogenous(from the body) and "orhphin" being short for morphine. Essentially morphine produced by the body. There are others, but we will focus on this one for now.

When you start putting exogenous opioids(oxy, suboxone/bupe, etc), your body recognizes this and does a number of things in attempts to correct the high level of opioids. It starts to produce less natural opiods, and then starts to make opioid receptors less sensitive to stimulation(receptor down-regulation). It can also start to increase sensitivity in other areas as well(receptor up-regulation). This is responsible for tolerance/physical dependence and the feeling that you'll never be happy without them again(psychological dependence).

The feeling that you aren't right without opioids(subs) is partly true. Since your body has adapted to the artificial level of opioids, without it them it will be running sort of haywire. The good news is that in the same way that your body has adapted to the artificial opioids, it can also adjust back to natural opioids. This adjustment process(withdrawal) is painful and very uncomfortable, but it is a necessary step in the healing process.

There are drugs, dubbed "comfort meds" that can help reduce the severity of WD symptoms and make the process much less painful, but these meds need to be used cautiously. The most commonly prescribed ones I heart about are benzodiazepines(antianxiety meds), sleep meds, and blood pressure medication. Anti-diarrheal meds, kratom, and DXM are some OTC meds that can be used as well.


In my opinion, I'd say stay away from anti-depressants until you have made it past the acute withdrawal phase. For buprenorphine, it's probably somewhere around 3-4 weeks for acute withdrawal. After that is what is called the post-acute withdrawal phase. You won't be dealing with things like RLS, diarrhea, or severe insomnia, but things like depression and anxiety will more than likely linger for a while. Things like running and exercise can definitely help, as they are natural ways to raise endorphin and dopamine levels as well as many other benefits. Getting proper nutrition on a regular schedule can help as well. Lots of people take vitamins and supplements like melatonin as well.

There isn't always something you can do to change or remove a feeling, sometimes the best thing you can do is to be with your pain rather than trying to run from it. It's natural to look for something to do when you are feeling anxious, but when you are feeling anxious because you are in withdrawal sometimes the best thing to do is to wait it out. Nothing is forever, including feelings. Thoughts pass and so do feelings. Learning to recognize the things that trigger negative thoughts and emotion can help you to avoid some of this but not all. Avoidance isn't always the best option either.. seeing a counselor/therapist and working through these triggers can help you overcome them so they do not dictate your life.

 

[neurogal]

I understand Joey. I struggle with depression and noticed that low dose opiates can have an amazing antidepressant effect. Obviously we all know it's not sustainable or desirable to do this daily or at all, hence your search for a long term solution. (I was addicted to heroin and then on methadone for a total of 10 yrs of daily opiate dependence. Even after being off methadone for 5 yrs, I've never felt like myself again and developed anxiety that wasn't there before. In the past year or two, I've taken a few pills here and there and didn't get faded, just felt normal again, which was a huge relief, to get that break, but also frustrating that i never feel that good normally.) It might interest you to know that there is a drug, CERC-501, in trials primarily for use in depression. Its buprenorphine/samidorphan. The FDA is heading for a likely rejection soon due to issues with study methodology. But I'm hopeful it will be approved in the future, or another one like it will be. I've read about a few ADs in development that work on the opiate receptor system, while blocking the intensely pleasurable effects or high, in order to discourage abuse. I do believe there is potential in drugs like this. Like you, I've tried the typical antidepressants and all I get is crappy side effects. I've also done CBT with a good therapist, and regular yoga (3x week). Both of those can produce improvement. I guess i don't have a good answer for you, as different things work for different people. And I haven't yet found a long term solution myself. Just want you to know you're not alone and to wish you luck. I do think it's worth a try to talk to a mental health professional, or maybe several, until you find someone good to talk to.

Btw if you do a very slow taper off bupe you will not be experiencing nasty physical withdrawals. I do recognize that you'll be left with the feeling that you posted about. Keep us updated on your progress and PM me any time.

 

[Rupert D]

Mafioso has given you some great wisdom there.

I'd say that if you want off everything then don't touch any substances; even the mild ones risk leading you back to using. I tried switching drugs and just ended up addicted to the lot and my mental health went down the pan. I went on kratom to stop opiate addiction about seven years ago and ended up taking opiates on top of that in the end. I've been on SSRIs the whole time and it was just a pointless fucking cycle. At the moment I'm trying to get into recover from a lifetime of poly-addiction and I'm of the impression that really I don't need SSRIs; I need sobriety and a program. But that's just me; that's not where everyone else is at. So if you want to try substances, try keep it low dose and take long breaks. In my experience opiates long term will not help. Neither will benzos. SSRIs are a waste of time if you're taking drugs regularly. But maybe there is something out there that will help you. People rave about psychedelics curing depression. If you don't ave addiction then there are things that may help. Just go easy and keep low dose and take massive breaks!