Opioids Heroin addict has to travel to rehab - help me get her through it, please!

[NikkiNumberNine]

Hello…

I haven’t been around much for a while, but back in my party days, this was my favorite place to get educated. Now I have a problem and need some advice. I looked around other threads, but I didn't see anything quite like this question.

A friend of mine (I’m not just *saying* that, this is really about a friend whom I love) has developed a heroin addiction. She won’t tell me exactly how much she’s using, but I think it’s about $200 a day, IV.

She’s not able to work, live her life, anything – it’s not even like she’s *enjoying* it, it’s all just about “getting well” and then in a few hours it starts all over again. Bad situation. It's been going on pretty bad for at least a year.

She says she wants to get off heroin, and I believe her, although I know it’s not just as easy as that. We’re in the Southeast, and I found a suboxone clinic I can get her into in California. Here’s the tricky part: I’m going to take her there, but that means I have to get her onto a plane, and that means at the very least 8-9 hours without her being able to have a shot. (Because we are NOT taking illegal drugs through TSA with us, no way.)

And the way plane travel goes these days, I want to be prepared for 24 hours of no heroin for her, just to be on the safe side.

BUT I don’t want her to go into withdrawal on a plane. (Can you imagine a worse place?) Let’s say I know a friendly doctor who will prescribe her something to get her through the trip in relative comfort: what should I be asking him for? (Yes, she’ll obviously be present for this doc visit, but if I’m the one taking her on the plane, I want to make VERY sure I’ve got what we need.)

What would make this easiest for her? I assume an opioid painkiller in pill form, but which one is best? Or is there any difference? I know absolutely NOTHING about pain pills, they were never my thing. How many would she need?

Would a fentanyl patch be better? Again, assume I know nothing about this category of meds.

Or should I try to get a dose of two of methadone?

Can you take stuff like valium or muscle relaxants at the same time as those meds? My instinct says no, but this is a heroin user we’re talking about, and again, I just want to get through this travel as easily as possible.

Any other suggestions for steering someone on their literal flight to freedom from heroin appreciated.

(I do know that yes, she may relapse. Many people do. But she’s still my friend and I want to be able to promise her that if she’s willing to get on the plane with me, I will keep her from getting dopesick while I deliver her to this clinic. )

 

[strigoi]

Yes, I can imagine a worse place, jail.

A plane is a bad place to OD too, so you need to forget about the fentayl patch and mixing downers with benzos (like valium) or muscle relaxers. No offense (since you are fortune enough not to have experience with opiate drugs) , but if your friend doesn't know what can hold sickness off for half a day then you need to consult a professional. If you don't know your friends tolerance for sure, then neither do we. You don't want to give her a cocktail that doesn't help her at all, or will put her to sleep for good.

 

[Larc]

24 hours without lady h isnt going to be thst bad. The sub clinic is going to make her wait atleast that long before induction.

More likely they will make her wait 3-5 days. The literature that docs go off claims 7 days no opiates before bupe induction and this is likely what they will go off of.

 

[Mad Dash]

If she will be present for the doctor visit I would say she needs to tell the doctor exactly how much she does so he can figure out her tolerance. If she knows how much Oxy she would need to get high that would be an even better place to start from. As with Heroin it is impossible to know the purity of it. So first ask her if she knows how much oxy she would need to get high. The just straight up tell the doctor the full truth. You will need to be holding on to the medication, and probably provide some proof that you got to her to the clinic. And I have to ask is this just an addictionologist that writes suboxone? Or is an an inpatient program?? If you take a flight just to get a RX for subs what are you going to do fly back out there every time she needs a refill? There must be a closer doctor if that is the case. Need more information and then I can probably help you a bit more.

 

[pillman1224]

no specific locations needed but where in the southeast are you? there are no sub docs there? if not find out how much oxy it would take for her to stave off withdrawal then either ask for a that or even better (or worse) get it from somewhere else ie. dealer. yeah it costs more but i would rather be flying with a few roxi 30s then a few grams of h.

 

[Phil.McKeer]

24 hours without lady h isnt going to be thst bad. The sub clinic is going to make her wait atleast that long before induction.

This, and...

no specific locations needed but where in the southeast are you? there are no sub docs there?

This.

In the grand scheme of things, if you do actually go through with the air travel to the west coast (as opposed to finding a sub doc/clinic, say, in your county), she's going to want to get the sub as soon as possible. This means you'll have to present her to the sub doctor when she is in full blown withdrawal, otherwise he won't dose her right away. You want her to be AT LEAST 24 hours off when she sees the sub doc.

Can anyone else chime in on this? I'm giving this advice assuming that sub induction takes place in the actual doctor's office, and then you get a prescription you can fill later. Is that correct, BL population?

Edit: But do take advantage of this generous doctor. I'd ask for Valium, brand name. Give her 10mg every 4-6 hours as needed and keep the whatever's left for yourself

 

[brandino34]

if your friend knows where to get heroin she should beable to find suboxone/subutex also. one or two strips or pills should be able to hold her over for the travel time. usually 24 after your last opiate dose is enough time to be clean to start using the subs. what I have always done is use whatever opiate I am doing the day before but take my last dose like 10 hours before bed. that same day I will try to stay awake as long as possible. like 30 hours or so. that way I am able to sleep like 12 hours. that way I can dose the sub like 2 hours after I wake up. this also gives me time to judge if I am withdrawaling enough to take the sub. the sub should hold her over for 24 hours which should be enough time for the flight and to find the clinic you are trying to find. a mild benzo like valium or Ativan may also be good for the anxiety of the flight and the lifestyle change.

 

[Bliss26]

Could she do medical detox in hospital for the worst and then go to rehab once she's stable

 

[LilikoiMoon]

Why so far away when there are closer clinics?

 

[speedballs_over]

^^ Exactly,, look up the bupe physician locator tool. I believe SAMHSA has a good one. Bupe is pretty profitable for physicians since they lifted the thirty patient restrictions at the federal level.

Call methadone clinics or a syringe exchange nearby (same state or within an hour drive approx) and ask them who prescribes bupe and call to see if they're taking new patients. Pharmacists may also be able to tell you. That's three possibilities to find treatment much closer to home, and much less expensive.l

Are you wealthy and wanting to take her to the Malibu Clinic (the one on the hill overlooking the beach), a Betty Ford center (not sure they do bupe) or a Hazelton type franchise?

If so, save the money, they're only more comfortable, not "better", relapse rates are kinda high b/c they baby the patients. But they're some of the better inpatient facilities. If your going to Cali for outpatient you're straight up throwing money away. Maryland is much closer, right?

 

[Mad Dash]

ya the location thing has me scratching my head... your location says seattle... but you say you in the southeast? Where exactly? Because if you are trying to go to malibu you might as well flush you money down the toilet. IMO the reason they have such a low success rate is on purpose. They have no aftercare since you are out of state, also they do not do 12 step therapy. So your friend goes there gets clean, but does not learn how to stay clean. Then because they dont encourage you to go to AA/NA she relapses almost immediately. Then you have to go back to Malibu again, and again. This place actually does not care about addicts. In the commercial he says "I use to be an addict now I'm not." Not only did he sound like a brainwashed twat but the fact is you are always going to be an addict. You can't just un-become it. Does not work that way. That is why IMO 12 steps have to be a part of any successful based program.

 

[cj]

Why are you getting on a plane to go o a sub doctor? I'm in the southeast and there are plenty of sub docs around here. Of your taking her to rehab that is different. I'd you have to fly anyway I would suggest she does a shot before going to the airport and just have benzos for the flight. She will be ok for 8-10 hours without opiates.

 

[mankind]

I am so confused by all of this.

You are from the south east, yet want to fly to California to see a suboxone doctor? In the hopes of what? Getting a 30 day supply? Why would you travel such large distance? What happens when the 30 days are up? Are you looking for an INPATIENT rehab? Every rehab I've been to will make you detox first at the hositpal for 5-6 days, THEN you go to an inpatient where they give you absolutely no drugs.


On a different tip, flying domestically and concealing certain quantities of drugs is remarkably simple, or so I've been told.

 

[R3hab]

Best of luck to you. Suboxone is great just make sure you dont stay on it too long

 

[speedballs_over]

OP - if you're around could you please answer the big ? What need is there to travel so far? Is she permanently relocating to Cali? I used to live very close to that clinic in Malibu, it's a good place to meet wealthy assholes, I'd hate to hear anyone waste good crash going out there b/c the famous get better treatment, in general no, they don't. Unless it's one of the high end methadone clinics, but then she'd have to move there.

What up? We tried to help, let us know please. That way we can file this under "remember what to tell the next person who asks this ?"

Thanks. Best wishes. Getting straight off dope ain't easy, and Malibu isn't going to help much, hell is hell. But within a few days of induction she'll be feeling quite good, and well on the road to recovery. No reason that can't be done in any of the fifty states.

 

[tacodude]

I do not know if I am too late, but find a local dr you can explain the situation to and even help set up everything with the clinic so as soon as you arrive treatment starts vs placement and paperwork while sick and miserable. Then explain to the doctor the fear of going through serrious w/d on the flight that may leave the patient in danger due to the mental state the suffering brings out. Ask the to help experiment by starting low and titterating up until w/d are managed while having the patient give consent for you to be recovery support by allowing you to hold on, dispense, and supervise the dosing to make sure it is used orally on time. If yoou can work this solution out it can be the best answer next to poppy seed tea, which could be another choice too.

 

[Mad Dash]

GARH! Who makes a post like this and then never comes back? This has been a exercise in futility.

 

[NikkiNumberNine]

Sorry, life has been a little crazy but I HAVE been checking replies. I myself think if you ask a question then you should shut up and let people answer, so that's my system.

The location issue is complex, but since you guys seem to care: I live in Seattle. My friend lives in a pisshole of a town in West Virginia. And there is NOT SHIT for recovery there. I went to visit her a month ago and saw how bad off she was, and since then I've looked, it's all either waitlisted forever or it's super gritty grim places that scare my friend. Plus, she need to be OUT of that environment if she's going to kick. There are other reasons for getting her OUT of the area as well, like an abusive ex that threatened her. I have a connection with a sub doc in CA, another friend who's a social worker there to help her navigate paperwork and ect, a place she can stay, it's all lined up. So that's where it's happening, she's not staying in the SE, that's not up for discussion.

I can take 4 days out of my life to do this (because I have bills to pay and stuff). I've been talking to her every day, telling her "Go to the doctor, tell him what's going on, try to get some meds" and she's like "oh yeah sure I will" but of course she's not. Me and another good friend of her are going down tomorrow and we're going to basically do an intervention and be like "we love you, you're in a really bad situation, pack a bag and come take a trip to California, and get out of this shithole and get your life back on track." And hope she goes for it. We think she will, she says she wants to get clean and she's really unhappy.

I got some 8mg suboxone films and I read this: http://www.howtoquitheroin.com/How_to_Help_Others_Quit_Heroin.html

So I'm going to try his suggestions, hopefully try her on small amounts of them once she's in WD while we're still on the ground, and figure out how to make her as comfortable as possible on the plane. Otherwise we'll just try some valium and immodium and stuff like that to try and control symptoms.

 

[cj]

Hell yeah bring her out to Cali! I was real skeptical but this makes total sense to me IF IF IF YOU are willing to follow through! If your not up too it don't drag her across the country. At the very least make sure she has a plane ticket home if everything goes to hell in a hand basket.

Suboxone is a good choice. It would be best to get her started on it the day before the flight. After 48 hours she should be stable and comfy enough to fly. There is TONS of I of on suboxone induction around this site and the Internet. Plus most addicts have some experience with it so it should be a piece of cake.

Feel free to PM me with any specific questions as I am online a lot and can answer them quickly. Good luck! Your doing a really great thing for your friend!

 

[Bropiace]

OP best of luck with helping you friend.

If she is open minded then it is a great thing you are doing. Remember that someone needs to be ready if they are to quit. It might just be the right time so good luck with that.

Now regarding the Sub you don't want to put her in Precipitated Withdrawal (Google it if you don't know what that is). It is actualy the worst thing you could do. I haven't read your link that was quite long but I wanted to let you know just in case. What would makes sens would be for her to kick the heroin while you guys are around and when she is showing STRONG symptoms then you can give her the sub and get on the plane. Or like Tacodude said have some doc script her Oxy starting with low dose and raising until the symptoms disapear.

But an addict usually knows his shit. She will know how much Oxy she needs. And if the doc won't help, if you got a bit of money, she might be able to score something Pharmaceutical off the street and that is probably what will keep her motivated. I mean, when the withdrawal kicks in some resolve goes down the toilet. So as long as she is maintained by some opiate, she might dream of a better life and agrees to go with you. Once she did it, got on a plane, moved, be in a new setting, she might feel like she already made it this far and go on. Last piece of advice, unless you really really really really trust her, maybe you shouldn't let her go with the money for the pills and stick with her while she is purchasing. Make sure to assess you do not put yourself at risk either.

I think what you are doing is really great and it is a good thing she has a friend like you. Remember also she is in a hard place and might not act like you have known her to. Good luck again and feel free to update us as to the end of that story.