Heroin to Suboxone...help/advise please....

[Zephyr_Dreams]

I have been using heroin for aprx 3 years. I started out 'dabbling' which progressed over a year. I was physically addicted for about 4-6 months (the time line is a bit foggy). My boyfriend at the time, a life long junkie, had previously used subutex, and was able to get me a month's worth prescription. At the time my daily heroin use was considerably lower than what I am now taking. I was able to somewhat painlessly transition from heroin to subs, and then wean myself off the subs within a month or so. I definitely still had a 'mental' addiction. The dreams were endless. I would take any oxy's, demerol, etc...whatever I could get my hands on really, whatever chance I could. However, I was not experiencing any kind of withdrawal when I was unable to get the pills. During this time I had moved away from California (where I had first become addicted.)

About 6 months later, I moved back to California. My father, my best friend, the most precious person in the world to me died unexpectedly. I had used a few times since moving back to CA, but after his death I used it as a coping mechanism, and before I knew it I was doing it everyday. It's been almost 2 years and I am doing anywhere from 1-2g a day. (More if I can afford it). I don't miss a day. I mostly smoke, and I smoke it all day long. I occasionally shoot up, but have to hide it from my boyfriend.

I am READY to quit. I need to quit. I can't live like this any longer. I am going to move home, where I have no connections, and a wonderful, loving support system. I have no access to suboxone or subutex through friends, so I am hoping to find a doctor who can help me.

I have some questions which I'm hoping someone with similar experiences may be able to help answer.

1. What is the likelihood of a doc prescribing me subs. How long will it take to get them, and how much will it cost without insurance? (I have a flight booked home in 2 weeks).

2. How long should it take to adjust from aprx 1g of heroin a day to subs. How long will I be in agony? If I go 6 hours without dope I start to feel shitty, 12 hours I'm in withdrawal. I don't even know what 24 hours feels like, as I haven't been there in 2 years.

3. Where do I find a doc who can help me (and I need it like, now, so I can make the switch and start to feel normal before going home).

4. How long do I have to be off dope before switching to subs? I put myself in preliminary w/d once and it's something I never want to go through again.

5. How and why did I end up here? How can I become a normal, happy, free person again. (This one is rhetorical).

Any advise would be welcome. Please be gentle, please be kind. There is no 'toughening up' and quitting cold turkey for me. I don't have the money for a proper intake rehab, so I'm gonna have to do this on my own.

Thanks

 

[THECATINTHEHAT]

1. Guarunteed if you are an opiate addict, there may be an issue as to whether the ceiling dose of buprenorphine is enough to cover your habit, but you should be ok if you're just smoking though. How long it takes will depend on the individual clinic/doctor, could be a day or it could be a couple of weeks. I have no idea about cost I'm afraid as I'm from the UK.

2. According to the guidelines you should wait at least 24 hours, more even, but I've waited less and I've heard stories of people switching over after 6-8 hours (although this is very risky). Generally if you just hold out as long as you can until you're in pretty significant wd (feeling really shitty, not just a few shivers) and then take the bupe the switch will be ok. The doctor/clinic will guide you through this process though.

3. Google and a telephone?

4. That's essentially the same question as 2, you wait the appropriate amount of time until you take the bupe after stopping with the heroin and you will (hopefully) just feel pretty normal as soon as you take it. There maybe a period of a week or two in which you feel slightly 'out of sorts' though.


The major issue you have here is that afaik there's not going to be any way around you being on supervised consumption tied to a clinic for a good few months. The doctor isn't just going to hand you a month's worth of bupe and send you on your way. Maybe things are different in America to the UK, but certainly it doesn't work like that here, and I'm pretty sure it doesn't in the US either.

The way it works in the UK is that you get assesed at a clinic and put on a prescription if they think it's the right thing to do (i.e. you piss hot essentially). You then have a period of a couple of months of picking up your dose and taking it supervised at the clinic/pharmacy; if you build up trust by pissing clean you'll then be allowed to take your meds away each day to take alone and given the weekend's meds on friday; if things are still good you'll then be allowed to pick up monday, wednesday and friday; if things continue to be good you'll then be allowed to pick up once weekly.....

I'm pretty sure it works in approximately the same way in America. It's possible to get your care transferred to a diffferent doctor whilst going through this process but I would have thought they will be unlikely to do so during the initial period of supervised consumption.

I'm pretty sure you're severely underestimating how tightly controlled the process of getting on to a script is. You can't just call a doctor, get them to give you a load of bupe and then disappear across the other side of the country (someone please correct me if I'm wrong though). My advice would be to actually get on the phone to some local clinics and speak to them about how they operate. I would prepare yourself for bad news though.