Considering Suboxone treatment, have a few questions...

[Doktah]

Hey everyone.

For the past 3 - almost 4 - years, I have admittedly had a problem with drugs and depression. In my first year of abusing drugs, I went on a crazy MDMA binge. This did an insane number on me; I STILL have an anxiety problem to this day (had ZERO anxiety before-hand). Up until a year ago, I basically did whatever I could get my hands on. Tons of cocaine. Tons of psychs. RC's...

A year ago, I discovered Opiods, and I basically left the old me behind with that first hit of oxy. I was addicted psychologically straight off the bat. It escalated within 2 months to me joining The I.V.y League and shooting up about 100 to 150 dollars of heroin a day. What made opiods so addictive to me, is that they COMPLETELY cured my depression (that I had since early highschool), my anxiety, gave me confidence, energy... I just loved the person I was on opiods.

Fast forward to today, I am currently maintaining from going into withdrawals on Poppy Seed Tea. If I stop, I go into bad withdrawals and - worse - the depression and anxiety return. I somehow still have a lot of good things going for me despite all this shit; I am going away to school in the fall to finish my final year in University computer science, and I am currently working at EMS doing local I.T support in my area. I have been doing extremely well at my job, people love me there, but it's only because of how lifted my depression is with the PST.

I have been considering suboxone for a number of reasons. First of all, I have tried to quit a number of times [opiates], and failed. A few times, I actually made it through W/D, and then went back to getting high because of my depression. I cannot afford the time it takes to scrounge for opiods this year at school, or the stress from having that monkey on my back, so I would rather just maintain on suboxone. It would also be highly beneficial for my depression; I have heard that although you don't get "high" on suboxone, for many, the anti-depressant qualities of opiods in general are there. This would really help me immensly with school, work, my personal life... and obviously to stay clean from other opiods.

I believe that the arguement that "Suboxone is an addictive narcotic and should not be used for depression" is bullshit. I have experience with cipralex, and let me tell you, I found the withdrawal from that shit just as bad if not worse then my withdrawals from heroin and oxycodone in it's own ways. So you can treat depression an addictive and shitty SSRI, but cannot with an addictive but highly effective opiod? Bullshit...

What do you guys think? I honestly - at this point - believe that this would be very beneficial to my mental health. Can family doctors in Canada prescribe suboxone?

Thank you in advance guys. Sorry if I rambled a little in my post. I really appreciate the advice you all have to offer.

 

[ArtVandalay]

I've been on suboxone for a year after a 6 yr poppy pod tea addiction. I suffer from anxiety and was using opiates to self medicate. Suboxone is a godsend. I was just talking to my doc today about suboxone's anti-anxiety properties, and how it's being studied as a medication for those that don't respond well to traditional anti-depressant's.

I've tried Zoloft and Prozac in the past, they just made me manic.

Suboxone could work for you if you work it. Meaning, not simply taking the medication, but also commiting to a drug free life and/or therapy/NA or similar drug rehabilitation.

For me, I have to exercise daily, do yoga/stretching to get the full rewards of suboxone. When I do, I feel hardly any anxiety, and I actually feel good. Like how I imagine most 'normal' people feel. I don't feel high- just healthy.

You'll encounter naysayers that claim you're just trading one opiate for another but I disagree. Suboxone not only took away my desire for drugs (I was also into meth, RC's, MDMA, etc) it helped me become a better person (volunteer work, reconnecting with family, cutting off ties with toxic people).

 

[Doktah]

Do you know how I might be able to get it perscribed in Canada?

 

[Vaya]

This conversation seems to be more appropriate for Basic Drug Discussion

TDS>>>BDD

~ Vaya

 

[effie]

Hi there, we're not here to help you get drugs prescribed I'm afraid, and we don't cover regional queries either.. all we can recommend is being truthful with your doctor; we can't advise you on what to say/do to get prescribed something any other way.. I would imagine you would struggle to find a doctor who would prescribe it "off-label" for depression though, especially given the lack of clinical evidence and trials - and also given your history of opioid abuse. However, being prescribed it for opioid maintenance is a different matter. Not sure what the system is in Canada but I am sure your family doctor could at least point you in the right direction.

Some studies have found buprenorphine to have some degree of antidepressant action, but the evidence is certainly inconclusive, and one study I found showed no difference between buprenorphine and methadone.. Here are some links you may find useful

http://clinicaltrials.gov/ct2/show/NCT00863291

http://www.oatc.ca/research/Depressive.symptoms.during.buprenorphine.vs.methadone.maintenance.pdf

http://www.nature.com/npp/journal/v34/n1/full/npp2008165a.html

http://www.psychiatrictimes.com/mdd/content/article/10168/1733207

Did you really find SSRI discontinuation syndrome to be as bad as opioid withdrawal? I know it can be unpleasant but I think it's unusual to find it that bad - people do vary though of course. Addiction, tolerance and withdrawal are 3 of the biggest reasons why opioids aren't used for depression; they seem likely to cause more trouble than they are worth, and may exacerbate depression on cessation if someone was to develop PAWS. Patients could potentially end up on huge doses as tolerance builds too, which would bring an array of potentially unpleasant side effects such as severe constipation, nausea and somnolence/lethargy (feeling wiped out or doped up).

A patient develops a fondness for opioids and moves on to other drugs, developing an addiction which could spiral out of control. Again, clearly this wouldn't happen to everyone, but it is someting to consider. Buprenorphine most definitely can be abused - take a look at some of the threads in OD - and it certainly can produce a high, so it's not immune from this risk.

Buprenorphine is supposed to be pretty difficult to taper off; I'd wager that the majority of patients would find it considerably harder than stopping an SSRI. People on maintenance often need long, drawn-out tapers before they can jump off, compared to the large number of patients on SSRIs who can stop with a minimal taper period. Granted, psychological addiction will play a part in someone on opioid maintenance therapy, but I think the point is still valid. I do accept that SSRIs can be very tricky to discontinue in some patients, however, and that although the duration of discontinuation syndrome is usually fairly short, in some people it can linger for a long time.

The other problem I have with using opioids for depression is that they are euphoric and lift the mood, but they don't actually treat the depression - they just mask it. Of course, we don't fully understand the psychopathology of depression by a long shot, but typical antidepressants aren't euphoric drugs - they work via a different mechanism. In my experience they allow a person to make the changes they need to make them happy, rather than imposing artificial elevated mood on someone. Buprenorphine may be different if it has intrinsic antidepressant action, but I would still be concerned about this,

I hope there is more research into this, however, as current treatments for depression are less than perfect - any new advances are welcomed

What medications have you tried for your depression so far? Have you looked into counselling/therapy?

 

[rolley rim]

Hello
Ive been on methadone for near 13 years now, recently moved to great britton, I tried to detox of my meth, had a hell of a time! I started using Gear (H) agian??? So I tried suboxone, it did take away the withdrawl, but i found i got really bad head aches from it, there is no high, it has naltroxone in it and the head aches seem to be uncureable, mostly because there is NO opiate you can take safely!! untill ofcouse 24hours, min of with d. Im back on methadone now 30 mils, It is NOT a over night fix, (opiate add.) Id think about methadone ? You can go down a mil a month even? or MMT. I do know that most clinics in ont. are starting to precribe sub. now, I did alot of research into freeing myself from opiates, but like you said, they do make life alot more tolerable!, This is why IM suggesting meth to You ? Get back to me if you want to ask any more, I TOO loved opiates the 1st time I tried them, 30 years ago!! Good LUCK!

 

[psilocybinsane]

Suboxone in Canada

IME methadone was always too easy for me to relapse on. But everyone is different. Suboxone was a complete miracle for me, there was no high I could achieve from it, and it controlled my withdrawals for so much of a longer time than methadone. I could take my sub one day, and if I had something big going on the next morning and forgot to take it, I wouldn't feel 100% but I certainly wasnt in withdrawal. It saved me big time to say the least. As for suboxone in Canada, it is approved for Opiate Substitution Therapy, but according to the College of Physicians and Surgeons of british columbia, ( http://www.cpsbc.ca/node/95/ ) physicians are required to have something called a Methadone Maintenance Exemption and take an online education module on suboxone before they can prescribe it. So Im thinking your family doc might not be able to help... There are suboxone doctors, and even though they are pricey, its hard to put a price on getting clean. I wish you the best of luck man. I was in the same boat, when I took opiates I felt like the most confident, happiest person, which is opposite of how I normally am. Im still learning how to be that same person without the assistance of opioids. Hopefully you can too

 

[Swimmingdancer]

Why do you think Suboxone doctors in Canada are expensive? In my experience they range from completely free to a very reasonable price (not sure if posting prices for things like dr's visits are allowed??) a month if it's a private clinic. The drug itself is much more expensive though, if you don't have prescription coverage (depends on the province and your income level and whether you apply).

 

[psilocybinsane]

Wow, completely free? That does make me happy to hear, Im in the US and yeah the prescription costs are god awful if you have no medical. Is Reckitt Benckisser (SP?) still the only pharm company with the suboxone patent? They really need to make a generic to help people in need everywhere.