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Opioids Helping loved ones with opioid W/D

StickyChron

StickyChron

Bluelighter
Joined
Mar 26, 2011
Messages
324
Location
Northern California
So my girlfriend is currently taking around 28mg of dilaudid a day. She hates herself because of it, she struggles with not being able to gain weight, and is just generally depressed and unhappy. She is going to get on Suboxone in the next week or so and plans to work her way from there. She wants to quit but doesn't know how, she goes to group meetings, has tried tapering dosage, ect and nothing has helped her, so she decided on bupe. I hope this is a good decision on her part, I don't feel right telling her otherwise because she needs to do something.

If anyone has any experience with this, and would like to send some friendly advice my way, I would greatly appreciate it. I want to help her as much as possible, and if I had some kind of fool proof plan to help her she would be ecstatic. I love her and i want her to have to deal with as little discomfort as possible, she's dealt with enough shit in her life and if i can help her get through this, her life will be so much better.

Thanks everyone.
 
She IS ready to quit, it makes her miserable to be dependent on drugs to feel okay. I just want to be as supportive as possible.

She needs some kind of help, I just don't know what to do.
 
I think Suboxone sounds like the next logical step, if she has tried tapering, groups etc to no avail.. except in the UK it would usually be methadone for 28mg Dilaudid or equivalent, then switched to buprenorphine once you had tapered down a little from the methadone. Has she tried one on one drugs counselling too? That can really help to look at what precipitated the addiction, what maintained it, and how she can adjust her thinking and behaviour to give her the best chance of successfully quitting. Some people need to be on maintenance long term, where as others can taper off quickly; the important thing is doing it the right way for her as everyone is different.

If she would like some advice and support I would recommend taking a look a The Dark Side forum on here, which covers addiction, mental health issues and general support for all the shit life can throw at you; it is full of lovely people, many of whom have been through drug addiction themselves. They have an opiate addiction megathread in their directory or you/she is welcome to start a new thread. There is also a Suboxone/buprenorphine megathread here in OD if she wants to find out more about how Suboxone works or has any specific questions.

You have to wait at least 24 hours (until you get proper withdrawal symptoms) before you can switch from an opioid like hydromorphone to buprenorphine but once she is on the bupe the idea is to find a dose that will stop her getting sick and maintain her. Tapering off it can be uncomfortable if done too fast, but if done carefully she should not find it too tricky. The hardest part is often challenging the psychological addiction, which is why I suggest drugs counselling..

Good luck, I wish her all the best!
 
Iv'e noticed more people stick w/ it when taken while withdrawling. When taken before, the brain/body doesnt recognize the benefits from it making you think it doesnt work (and possibly causing precipitated w/d's) I believe this is a big benefit when starting buprenorphine maintanence.
 
I've done lots of reading about the pharmacological effects of bupe alone, and vs other opiates. As well as any known interactions because she takes mood stabilizers, and anti anxiety meds as well. The big and dandy thread has been invaluable to me.

Have you personally gone through a drug counseling program, if so, what did you find was their focus? Was it the psychological focus, or just generally "you + these things always equals _____" she doesn't need someone else telling her she's crazy lol. If anything I could probably help her on a level that would be more beneficial to her. I've known her for 9 years and I fear many of her problems stem from things I've done.
 
My advice is when she on a dose that works is dont let her get in a hurry to start tapering! The fact is addiction is a disease that has no known cure. You can take subs and feel sober if that makes sense. Take your time.
 
^ Good advice, I'm going to make sure she takes her time and doesn't try to rush it because if she fails she'll get so frustrated and relapse. Ive dealt with my own personal addictions, but never had to be the backbone for someone else's recovery. Thanks for all the info so far everyone, keep it coming.
 
Drug counceling programs are VERY hit or miss. It took me about a year of really trying and struggling to find what worked to get myself into a good one. The best thing to do, imo, is to remind her that she can do it (more so that she CAN do anything she sets her mind to) and be supportive that such ways as that, while also making sure she doesn't bullshit herself (i.e. I can't do this, etc. etc.).

Given that she'll be working with a sub doctor/psychiatrist, it's probably also a good idea for her to work one-on-one with a psychologist. That, a good psychologist I mean, often seems to do as much if not more than a group counseling setting.

TBH, it's very likely SHE won't be able to "recover" if it's your intention to be the "backbone" for her recovery. She has to do it for herself. She has to do it on her own. You cannot do it for her. This, my friend, is a cold truism.

Of course it would be infinitely nicer for someone who cares like you to be there to support her on this, day by day, as it's gonna be a real process to say the least. If you can set good examples of healthy living and healthy habits for her that would go a very long way in terms of her following your good example.

This is her fight, not yours. It is awesome you want to see her healthy and happy, and are willing to do whatever you can to support her in her struggles, but, at the end of the day, she's going to do what she want/what she believes she can do. This is why I say that A) setting positive examples for her are important (and of course helping teach her your methods for doing such) and B) reminding her that she CAN do whatever she wants are the two most important thing.

Oh yea, and keep an open mind. You cannot predict what'll happen to opioid addicts. She might relapse. She might not. If she does it's not the end of the world. All the more power to her if she doesn't. Regardless, it'll be a struggle.

But there is no reason she can't do this. Or that you can't stand by and help the "magic" along. I wish you both the best.

BTW Have you posted about this in The Dark Side? I think you'd get more better responses there.

Lastly, there is always Al-Anon/Nar-Anon, but it doesn't seem like they'll really be your cup of tea. Regardless, they might be worth checking out (they've helped my mom a lot, but I can't imagine that her issues are yours). Regardless, I say again, good luck!

p.s. I LOVE suboxone. Not going to say it saved my life, but in a way, it kind of did. That being said, it is my world view/mind set now that seems to make the most difference. A process of coming to terms and being at peace with everything I've done, who I am and what I'll be.
 
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StickyChron said:
I've done lots of reading about the pharmacological effects of bupe alone, and vs other opiates. As well as any known interactions because she takes mood stabilizers, and anti anxiety meds as well. The big and dandy thread has been invaluable to me.

Have you personally gone through a drug counseling program, if so, what did you find was their focus? Was it the psychological focus, or just generally "you + these things always equals _____" she doesn't need someone else telling her she's crazy lol. If anything I could probably help her on a level that would be more beneficial to her. I've known her for 9 years and I fear many of her problems stem from things I've done.
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I haven't been through it myself - well, not specifically for drugs, anyway; I've had general counselling and CBT. The advantage of a therapist, especially a specialist, is the training and insight into the psychology of addiction (if you get a good one) but also the outside perspective on it all. It might put a strain on your relationship too if you are trying to be your girlfriend's therapist.. especially if you are blaming yourself for her addiction. I do see your point however.. A bad therapist is less than worthless, a good one can really turn things around, but having a supportive partner (or friend/family member/whatever) helping you through is essential IMO. Your girlfriend is lucky to have you :)
 
PlurPsyed said:
Benzos. Just make sure to regulate her dosage
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My only question is: Would their potential benefit to her outweigh their potential risk (which would be moderate-high)? One of the last things I like to see is a former opioid addict becoming addicted/dependent on benzos (this also goes for booze, which apparently is the number one drug that fucks recovering opioid addicts over). CNS depressants can be tricky with populations prone to dependency.
 
toothpastedog said:
My only question is: Would their potential benefit to her outweigh their potential risk (which would be moderate-high)? One of the last things I like to see is a former opioid addict becoming addicted/dependent on benzos (this also goes for booze, which apparently is the number one drug that fucks recovering opioid addicts over). CNS depressants can be tricky with populations prone to dependency.
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it depends on the person really. To the OP: look into something called serax (don't remember the generic name) it's a benzo used to treat alcohol withdrawal but works with opiates as well. And once again, regulate her dosage, be the one to dispense them to her so she won't abuse them. Hope this helps
 
I really do need to recommend a detox program. You get bup from doctors who want you DETOXED as quick as possible, rather than ones that want your money from a maintenance program. And it doesn't have to be some long ass program, 7-15 days is an amazing amount of time to spend outside the real world and in a controlled environment. I have been out about 2 weeks and quit a 2 year dope habit in 15 days and haven't relapsed. I think there's a lot to be said for that.

As far as my CDSU, it was somewhat psychological and about what other underlying problems you have, but they leave most of that shit for the doctors and psychiatrists when you get out. What we mostly focused on is what your triggers are, how to avoid them, and just figuring out better ways of living so you don't feel you need dope in your veins 24/7. As far as people telling you your crazy? Bro, she's gonna get there and realize that she's probably the only one who isn't a heroin addict, and she'll probably feel pretty good that she never got into dope haha. That's how it was for the one pill addict who came through when I was there, we were all shocked... "YOU MEAN YOU'VE NEVER DONE HEROIN?! THAT'S CRAZY!!!" haha. It's nice to be able to relate to people going through the EXACT same shit you are and who can understand your stories to a T. You may love this girl to death, but if you aren't a dope fiend, she just can't relate to you on all levels.

I think if you're really ready to quit, inpatient is the best route. Why go through the trouble of doing it on your own when you can have nurses and doctors to assist you 24/7 and your in a controlled environment where you don't have the option to use no matter how bad you may get a craving for. Inpatient isn't for crazy people, it's for sick people, and any real opiate addict knows JUST how bad our sickness gets. I'd really recommend it.
 
StickyChron said:
I've done lots of reading about the pharmacological effects of bupe alone, and vs other opiates. As well as any known interactions because she takes mood stabilizers, and anti anxiety meds as well. The big and dandy thread has been invaluable to me.

Have you personally gone through a drug counseling program, if so, what did you find was their focus? Was it the psychological focus, or just generally "you + these things always equals _____" she doesn't need someone else telling her she's crazy lol. If anything I could probably help her on a level that would be more beneficial to her. I've known her for 9 years and I fear many of her problems stem from things I've done.
Click to expand...
I would recommend having her see a therapist. I have been to plenty of group meetings at outpatient drug programs, and I never got anything out of them. I did however benefit from the one-on-one counceling there since it was focused on my personal life instead of all of the repetitive topics that were discussed so many times in group.

G_Owl$ said:
Why go through the trouble of doing it on your own when you can have nurses and doctors to assist you 24/7 and your in a controlled environment where you don't have the option to use no matter how bad you may get a craving for. Inpatient isn't for crazy people, it's for sick people, and any real opiate addict knows JUST how bad our sickness gets. I'd really recommend it.
Click to expand...

Being on suboxone has some benefits over just going to inpatient detox to kick. You are not exposed to the real world while in detox, so once you get out it can be a shock to have to suddenly deal with everything while you are clean for the first time in a while. The detox may be easy under 24/7 medical supervision, but that won't matter if you go back to using shortly after leaving.

Suboxone maintenance allows you to learn how to cope with your addiction in everyday normal life without having to worry about relapsing since you have the suboxone in your system. Once the person has made changes to improve their life and they decide to get off of suboxone, they can slowly taper off of it.

Most people are addicted for years when they seek treatment, so going to a detox for a week or two isn't much time to address years of drug abuse thoughts and behavior. That's why a longer suboxone treatment will work better, especially alongside therapy. I'm glad that you have been clean since detoxing, but I think that the OPs girlfriend will be better off going on suboxone maintenance.

On the topic of different types of treatment, we had some good discussions about the effectiveness of different kinds of rehabs here:
Rehab- Is it effective?
 
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This thread is bumming me out. I'm addicted to opiates. Half my family is in one way or another... It's not the end of the world to need to take a few pills a day. I've had addiction threaten my future and have a very negative affect on my life. But it doesn't have to be so bad. People take opiates for a reason, just like any other drug. There's a problem that needs to be fixed.

Maybe I'm playing the devil's advocate here, but if her addiction isn't threatening her health or causing her financial/social strains... maybe it's not the worst thing in the world. I've come to terms with the fact that I need to take a few pills a day. I'm glad I'm not shooting up anymore and that I've found a nice balanced place. Maybe she just needs to see this situation in a more positive or laissez faire light. It's just a few pills a day to make you feel better. No different than an anti-depressant or pain medication.

This may not be a popular view, but as long as you're being safe and can afford it... what's the big deal?
 
I would say Suboxone is the only way to detox from Opiates! PERIOD, I was on Subs and it saved my life!
 
Detox is the easy part. Hell, I've detoxed over 10 times. (clean time ranges from 3weeks to 3months, not counting methadone or bupe)

After getting clean, the feeling to use will be there still. She may or not act upon it, but it stays for awhile; regardless of how much you want to stay clean. Bupe will keep the urge to use away while she gets her life back together. Then, after she gets her life and health (mental too) together, start a taper down. Much easier to taper off bupe than hydroM.

Nice thing about bupe is it's not really intoxicating, allows you to go about your life as normal, no need to goto clinic everyday, and it keeps the desire to use away.

I know she doesn't want to use to function, but she has a much higher chance of getting there if she uses bupe for a while, instead of just stopping the HydroM.

I'm not a big fan of inpatient first off cause noone is in their right mind during and after a detox. And second, like a poster said above, it isolates you from the real world. I think it's hard to develop coping skills in an artificial environment.
 
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