Opioids Doctor supervised opioid maintenance - not methadone nor buprenorphine.

[infinite indigo]

Im too the point to where I am not buying anything else off the street if I don't have to. Enough time has gone by and there are no more games anymore. This has now turned into a full blown health and harm reduction issue. I believe that my quality of my life would exponentially improve if I didn't have to worry about all the problems associated with physical dependence. My health would greatly benefit with legitimate use as well. I wouldn't have to worry about the bioavailability or ROA of making something last because of how much money I have or someone else's supply/using needles/succumbing to talcosis or silicosis. Im also losing thousands and thousands of dollars. I want to start seeing a pain management doctor, and I have no medical records. Only a huge tolerance that is followed by serious and unmanageable withdrawal with a serious desire to AVOID SUBOXONE AND METHADONE, the government cheese's of medication, at all cost. Those do more harm than good and I would actually sue someone if they had me on it for more than a week.
A paradigm shift needed to occur in the states YEARS ago. And my health and well being are suffering because of it. What kind of success have you had getting off the street and changing your life though maintaining and eventually tapering with a pain management doctor without the use of suboxone or methadone? Are we such a dumb society that we cannot see the obvious when it comes to opiates?
Ive been withdrawaling off suboxone for almost a month now. And you don't see a problem with that?

Methadone and buprenorphine are a HUGE problem themselves, aside from the insanely irrational pharmacokinetics, but also what they represent.
Every other place on planet earth GETS IT except for the united states.

<snip>

 

[amapola]

The availability of this treatment method will depend on your location and the applicable laws and medical policies. I don't believe that most other countries besides the states routinely prescribe "abusable" opioids to maintain pure opioid abuse, but I could be mistaken and would be interested to see if anyone has been treated like this.

I'm afraid your personal situation may get a bit lost in a generalized discussion so I'll mention now that kratom is legal in the United States and it contains opioids which might help in a maintenance situation, though depending on your tolerance the effects could be quite limited. For help dealing with withdrawal symptoms in general you can refer to The Opioid Withdrawal Megathread and FAQ and things like loperamide.

I also think you need to clarify if you are speaking about indefinite long term maintenance or just being medically tapered on short acting full agonists.

 

[Captain.Heroin]

I strongly disagree. Try going to Asia, and see what they do to drug addicts there, and come back and tell me that only the US doesn't get it. 8)

Just because methadone or buprenorphine didn't work well for you, that doesn't mean that both of these have worked well for many people.

 

[ejnjgrl822]

i have doubts that a doctor would put a drug addict on opiates to keep them from buying off the street regardless of how bad your withdrawal and dependence are. a doctor wouldnt prescribe a medication thats not for the purpose it was intended for. if doctors would do this dont you think wed all be sitting waiting at the office right now? i mean it does depend on where you live and if there was a crooked enough dr that would give a known addict a prescription for your DOC. a doctor could loose theyre license for that. unless you have (i think its) an mri showing something wrong your not going to be put on opiates. were all pretty much stuck with suboxone, subutex, and methadone.

 

[mr. mudd]

There are docs who will do this--I had one who gave me liquid morphine for harm reduction. He was forced to retire.

The problem with short-acting opiates is it's incredibly difficult to stick to your dose--the body gets used to the dose and you end up wanting more. I appreciate as much as anyone how crappy it is to come off long-acting opiates, but the one positive thing I'll say about them is it's possible to use the same dose without craving more.

If your goal is to stay on opiates, then you're in for a lifetime of mostly unsuccessful doctor shopping. If your goal is to get off them, then you could taper orally in a week or two without spending "thousands and thousands" of dollars.

 

[OEandricearoni]

You say your life would greatly improve if you didn't have to worry about physical dependance, yet you're looking for a doc who can prescribe you full agonist opiates so you can get high legally? Wouldn't it be easier for you to just do a quick taper with whatever your DOC is? For some reason you seem to be adamantly against sub and methadone. and to be honest i don't blame you, but you have to keep your options open. It's highly unlikely you're actually going to find a doctor who will prescribe you opiates when there isn't actually anything wrong with you except that your addicted to them. Unless you find a crooked dr. that is willing to do that you're screwed.

Try rehab or a taper with a full agonist(since the wd's wont last as long as sub) other than that, i don't know what to tell you man..

 

[mrflowers00]

suboxone is horrible but subutex is a god send

 

[amapola]

The problem with short-acting opiates is it's incredibly difficult to stick to your dose--the body gets used to the dose and you end up wanting more.

This is a valid concern. That being said why then do they not prescribe bupe and methadone more often for actual pain as well? Because of the complications, side-effects, and general inconsistencies found after prescribing long acting buprenorphine and methadone perhaps...

a doctor wouldnt prescribe a medication thats not for the purpose it was intended for. ...unless you have (i think its) an mri showing something wrong your not going to be put on opiates. were all pretty much stuck with suboxone, subutex, and methadone.

Opioids are legitimately prescribed for pain management. Opioid withdrawal (and more subtly addiction) is pain. Doctors tapering addicts on full agonist short acting opioids is not out of the question if they had a medical reason to get on them, but maintaining them on it apparently is a no-go and if they got addicted illegitimately then "no drugs for you!" Who are we to judge how they got dependant? We should treat them all the same regardless.

i have doubts that a doctor would put a drug addict on opiates to keep them from buying off the street

What is to be lost in giving an addict their drug of choice as a safe alternative to the street? The problem is the general populace and lawmakers don't know that most opiate addicts don't enjoy being addicted. They think that giving treatment to them in the form of their DOC is merely sustaining their fun loving devil may care attitude. In fact it would be a legitimate out and a way to help have a life while addicted (thereby decreasing the chance of becoming more addicted). The general populace doesn't realize that nobody wants to be addicted to anything.

 

[amapola]

suboxone is horrible but subutex is a god send

They both have the primary active ingredient of buprenorphine eh?

I personally think a blind study would find little difference between the two with possibly a slight increase in headaches with those administering naloxone. Do you have any academic articles to support that statement or is it just your point of view. Not that your point of view is illegitimate as clearly it is how you feel of course

 

[smackcraft]

I strongly disagree. Try going to Asia, and see what they do to drug addicts there, and come back and tell me that only the US doesn't get it. 8)

Just because methadone or buprenorphine didn't work well for you, that doesn't mean that both of these have worked well for many people.

Sorry to go slightly off topic here but how do they treat them in Asia ?

I just tried google for an answer out of curiosity but nothing really revealing came up tbh

 

[OntarioGuy]

I think this type of maintenence works great,but you have to stick to it.Canada is good about this.I know several people,myself included that ger scripts of our DOC for the sole purpose of maitenence and to get away fro the street scene.My doc gives me MS Contin,my friend Erin gets 2 OC 80's a day.most of us are on daily dispensing,but some are on weekly(I used to be)

You may have to be willing to taper off over a period of 2-3 years though.

and yeah they are short acting opiates,but this is where daily dispensing comes in,you never run out 2 days early,no one can ask you to sell them/lend them out etc...

If you live in the US,you'll probably have a hard time getting this.but ultimately for me,when I dose,it satisfies the addict in me much more then methadone,which I think is key in keeping me away from other opiates,prescription or illicit.

Also,some doctors realize when you go in and admit you're an opiate addict and need help,you are long past the point of getting high,your main goal has now become feeling normal and avoiding withdrawal,so much so that you told a doctor that you abuse opiates.

My doctor gives them to me so I can live a normal life,like date girls,maintain my job etc...

 

[muvolution]

You are right, nobody wants to be addicted to anything.

which is why I don't understand why the OP doesn't do a taper with bupe. Just getting bupe was a HUGE step forward for the United States in drug treatment. I agree that it isn't perfect but I truly think that the (very few) programs in the world that give heroin to (very few) people who cannot successfully kick it is misleading. Most of those people have tried quitting, both CT, and with the assistance of maintenance drugs numerous times, and they have the health records to prove it.
It is misleading for people like the OP who think they can be put on without having demonstrated a true desire to quit like everyone in these programs has.

 

[OntarioGuy]

^Yes alot of us who have sripts have failed CT and Methadone treatment.Ive been enrolled in the methadone program 4 times.When I first got a script for OC there wasn't a methadone clinic in my town,so they maintained me on oxy.

Also,the doctor will give you just enough to stop withdrawal,not get high.for example,my first script was for 3 80's a day when I was doing about 6 a day.And really that should be all you need.

I dont disagree at all with this method.Ive seen people get off in 3-4 months with this method,while I know people on methadone who have been on it for 25 years.(all the people I see at the clinic here have been a client there for years)

for some,bupe and meth work,for some people it doesn't.That's just the way it is.

I would talk to your doctor about daily dispensing.(e.g. go to the pharmacy every morning if possible to pick up your 3-4 pills)

 

[Captain.Heroin]

i have doubts that a doctor would put a drug addict on opiates to keep them from buying off the street regardless of how bad your withdrawal and dependence are. a doctor wouldnt prescribe a medication thats not for the purpose it was intended for. if doctors would do this dont you think wed all be sitting waiting at the office right now? i mean it does depend on where you live and if there was a crooked enough dr that would give a known addict a prescription for your DOC. a doctor could loose theyre license for that. unless you have (i think its) an mri showing something wrong your not going to be put on opiates. were all pretty much stuck with suboxone, subutex, and methadone.

People have been put on opiates without an MRI, although there probably are not a plethora of doctors willing to do this anymore.

Simply an Xray was good enough for me.

 

[Captain.Heroin]

Sorry to go slightly off topic here but how do they treat them in Asia ?

I just tried google for an answer out of curiosity but nothing really revealing came up tbh

I guess you have never read this thread then?

 

[NeighborhoodThreat]

^Exactly. Most of the time they at least want some sort of X-ray image. While it is possible to fake being in pain, its not possible to fake a broken bone.

 

[infinite indigo]

I strongly disagree. Try going to Asia, and see what they do to drug addicts there, and come back and tell me that only the US doesn't get it. 8)

Just because methadone or buprenorphine didn't work well for you, that doesn't mean that both of these have worked well for many people.

True.. I will admit that bupe has worked well for me before in the past, but only for a few days.. Anything longer than a 3 or 4 days in my opinion gets close to doing more harm than good due to the half life. Yea thats true! Death!

http://www.foxnews.com/story/0,2933,458765,00.html

The third paragraph down nails it -

 

[infinite indigo]

There are docs who will do this--I had one who gave me liquid morphine for harm reduction. He was forced to retire.

The problem with short-acting opiates is it's incredibly difficult to stick to your dose--the body gets used to the dose and you end up wanting more. I appreciate as much as anyone how crappy it is to come off long-acting opiates, but the one positive thing I'll say about them is it's possible to use the same dose without craving more.

If your goal is to stay on opiates, then you're in for a lifetime of mostly unsuccessful doctor shopping. If your goal is to get off them, then you could taper orally in a week or two without spending "thousands and thousands" of dollars.

Thats too bad mudd.. I would actually disagree about "it's possible to use the same dose without craving more". I believe it is possible, but more than likely after enough time has gone by you'll find your way back to square one craving more - it comes down to physics and pharmacokinetics. For example, after having been on 12-14 milligrams a day for a year I can with confidence say I reached a level where 12-14 milligrams wasn't doing anything and I needed more. Thats actually the reason why I decided to stop and start using again, trying to establish a more manageable base.

 

[smackcraft]

I guess you have never read this thread then?

If i have i wouldnt of remembered, i was an awful state back then lol

reading now ta

 

[infinite indigo]

This is a valid concern. That being said why then do they not prescribe bupe and methadone more often for actual pain as well? Because of the complications, side-effects, and general inconsistencies found after prescribing long acting buprenorphine and methadone perhaps...


Opioids are legitimately prescribed for pain management. Opioid withdrawal (and more subtly addiction) is pain. Doctors tapering addicts on full agonist short acting opioids is not out of the question if they had a medical reason to get on them, but maintaining them on it apparently is a no-go and if they got addicted illegitimately then "no drugs for you!" Who are we to judge how they got dependant? We should treat them all the same regardless.


What is to be lost in giving an addict their drug of choice as a safe alternative to the street? The problem is the general populace and lawmakers don't know that most opiate addicts don't enjoy being addicted. They think that giving treatment to them in the form of their DOC is merely sustaining their fun loving devil may care attitude. In fact it would be a legitimate out and a way to help have a life while addicted (thereby decreasing the chance of becoming more addicted). The general populace doesn't realize that nobody wants to be addicted to anything.

Amapola that was an unbelievably remarkable post.

To the above poster that suggested I had an addiction problem, you ought to read the last paragraph of Amapola's post and do a little bit of research. I think you might find that addiction and physical dependence are separate entities, commonly but not always mis-diagnosed.