Need advice on how to deal with the sub clinic
I went to the sub clinic for my first meeting on wednesday, because I want to enroll in subutex treatment for my heroin addiction. My general patterns of addiction are as follows:
For almost two years, I have been experimenting with heroin, snorting for the most part, but also chasing the dragon on very rare occasions. In the beginning, I would use between 100-250mg/day, but it quickly escalated to 0.5g and over, with maximum daily dosages reaching about 2.0g. I have had periods ranging between 1 week-3 months, where I have been clean, and numerous times, I have experienced the full force of the dope sickness. I thought that I had mastered my addiction during the summer of 2010, where I had been clean for 3 months due to work abroad and field courses for university. When I got back from a busy summer of field work/courses in septemeber, I relapsed on heroin, and have been using daily since. These days I manage to get by on 0.5g, but that includes waking up in a shitty state, and constantly having to tell myself not to go all out and finish my stash. It would really suck if I used too much one day, and on christmas day with the family ended in full blown wd's. During periods of not using heroin, I tend to drink a lot on occasion(2-3 times per week), and smoke spliffs in moderation. Also, before starting on heroin, I used to drink a lot of potent opium tea, and I have experimented with kratom extracts, morphine, codeine and methadone. But all these never really got me hooked like heroin has, but of course were part of the journey towards addiction.
So I am starting on subutex the 27th of december. My main reason for not just going through the wd's of dope is that I am at the brink of getting my bachelor's degree, and I will compromise this if I go into wd's now, considering that I still have a shitload of work to do on my bachelor's project, with the deadline coming up mid-january, and after submission, I have to defend it with an oral presentation of my work. So dope sickness, no thank you. I also have this problem that I am fine when I am in natural surroundings, usually abroad during holiday or field work, and when I am in these settings, I barely think about opiates. I always end up relapsing when I have to get back into the daily routine of things at home, work, lectures, homework, etc. So I need to find out for myself that I can actually make it through a day at work without heroin, and this I will do first by maintainance treatment until I finish my bachelors, and get started on my masters, and then I will taper off over a month or two.
How do you go about getting what you want from the sub clinic? They have already recommended an external intensive treatment programme, where I have to give up school and work for a while to conquer my addiction. Although this might be beneficial in some ways, it is really the opposite of what I need. Because if I go away and get clean, like I have done while on field work or holiday, then when I get back to the real world, I am just back at square zero again, and will probably relapse. This seemed hard for the doc and counsellor at the clinic to comprehend, and I am afraid that they will end up signing me up for some program that really wont help me at all, and that I will ditch it and end up back on heroin. Plus my doc and counsellor have no idea what its really like to be a heroin addict. I mean they've worked with addiction and so on, but have never been hooked on junk themselves, so who are they to give me advice, really? I also have an issue with trust with the clinic personell, and they need to know all sorts of personal details, which I am reluctant to tell them. But I know it's for my own good if they can paint a picture of who I am and how my addiction has unfolded over the years. I also have an issue taking advice from people who are A) generally not as smart as myself, B) have personality traits that I have contempt for, and C) haven't been in the same position as myself. In other words, I don't like the personality of my counsellor, and I think that I am smarter than him, and he hasn't been a heroin addict himself. He has been a speed addict, and is now cured and working for the clinic helping others. I really hate this too, because he acts as if he is some self-proclaimed angel, who has been through it all and now wants to help others through addiction in ways that he managed to cope with it. For one, he has no idea who I am really, and secondly, I hate that he automatically thinks that what worked for him will work for me. Just wanted to add that take the word 'hate' in the various contexts with a grain of salt... I am exagerating a bit, but nonetheless, it was the first word that came to mind, so it stays.
What I want from the clinic is as follows, and I would like advice on how to get it:
-I want to be given subutex for a week at a time, even better if I can be allowed to pick it up at a pharmacy.
-I want to have to come to the clinic for sessions as little as possible, maximum for an hour once a week.
-I actually just want to deal with the doctor, and not the self-proclaimed angel getting in the way of my medicine.
-I want to control the situation, and not let them control it. I want to be the one who chooses when to start tapering, in other words, the tempo should be at my command.
-I need them to know that I have resources that are much more helpful and reliable than they are(e.g. Bluelight), and that I actually know more than they think about addiction and the pharmacology of opiates. Basically, they should stop treating me like a stupid child, just because I am a heroin addict.
-Basically, they are just supposed to give me the meds, and other than that leave me alone, until I ask for their guidance or help.
-My plan is to do maintainance with subs for about two months, and during that time get started on some sports activities, and get into the routine of studying/working without heroin. This may require a few months extra, until I feel like school is going well, and that I have activites that I am enjoying doing in my free time. Once my life is stable in that way, I will start tapering. And hopefully all of this can lead me to being clean within the next 4-6 months. After that I want to stay away from opiates and alcohol, and only do other drugs that do not lead to me wanting opiates to handle the comedown/downside of the drugs. Alcohol hangovers for example make me really wanna get high on smack.
All these worries came from just 1 meeting, but I still want to go through with it, so I hope I can get some advice from those of you who have been in maintainance treatment, and have worked with or as addiction counsellors.
