As I've seen many here noticed, there's a lack of understanding by certain doctors in the US of how buprenorphine should be used. I can just confirm that it's not very different in other countries in Europe as well.
I've enrolled into the first phase of buprenorphine trials in my country which was somewhere in 2012. Beforehand I used heroin more or less on a regular basis since 2005, with few breaks here and there lasting for 3 to 6 months each time. Let's say that the 2005-2008 period wasn't that intense as 2008-2012. During the first period I've used (by insufflation) heroin for few days a week, usually not every week in a given month, and also not always one day after another - there'd often be a day or even two before next use. The other period was progressively more intense, and as the 2012 was approaching I've experimented more and more with IV use, but I still haven't switched completely.
Starting buprenorphine on 2012, it was said that we'd be maintained for a period of few months and then tapered off, but most patients actually requested higher and higher doses, which was allowed to them. I was actually among those who used it moderately since I've started with 2mg and raised the dosage for another 2mg twice during the 2012-2016 period, ending in 2016 by using 6mg daily. I know of guys who were prescribed was over the proposed maximum of 16mg, some up to 32.
Then, in 2016, I've got fed up with it. Buprenorphine made me unmotivated to have any form of social life. An opportunity came to move to another country and I used that moment to get off of it - and man that was an experience. I've depleted my stocks of the medication before I managed to taper off properly. I had withdrawal that lasted for a month and was way worse than any heroin withdrawal I had. I also didn't have access to anything I could use to ease it effectively (like tramadol, for instance), and my local psychiatrist happened to have went abroad to attend some convention. The ordeal ended once I've returned to my hometown after that month of agony and was given carbamazepine by my psychiatrist. I was surprised how well it worked because I didn't expect any improvement of my symptoms - but it instantly returned me to feeling completely normal.
What probably helped me in the next period to stay off those things was that I again moved abroad - a new environment that has no cues that would remind me of my former opiate use and no people from my "past life". All that time I've continued using naltrexone, just in case, having a reliable person to keep an eye that I don't start avoiding it.
As the time went by, I started developing anhedonia and lack of motivation, to the point that now I feel as if I'm not myself anymore. I also have problems with memory and attention that I think are caused by the two previously mentioned.
During the last year, I've tried paroxetine for few months, then tried stopping naltrexone. Paroxetine made things somewhat better at the beginning, but then returned to having no positive effect at all. Quitting naltrexone also didn't improve anything. I even did cocaine for a short period and stopped because I couldn't get properly high off it - only the first time I took it did I feel that characteristic high. The next 8 times I used it, which happened over a period of one month, felt like taking a very low quality amphetamine - I'd feel some pleasure for 30 minutes or so, and then start feeling agitation and unrest until the next dose - each following dose bringing less pleasure and more agitation.
I'm not sure what else could I try. I'm planning on checking my endocrine system, thyroid in particular, to see if maybe the cause is something else. My overall health is good, immune system is working well and bloodwork is also good, with cholesterol and triglycerides slightly elevated when I last checked. Still haven't re-checked, but I believe those two should also be back to normal, given that I adjusted my diet accordingly.
I've enrolled into the first phase of buprenorphine trials in my country which was somewhere in 2012. Beforehand I used heroin more or less on a regular basis since 2005, with few breaks here and there lasting for 3 to 6 months each time. Let's say that the 2005-2008 period wasn't that intense as 2008-2012. During the first period I've used (by insufflation) heroin for few days a week, usually not every week in a given month, and also not always one day after another - there'd often be a day or even two before next use. The other period was progressively more intense, and as the 2012 was approaching I've experimented more and more with IV use, but I still haven't switched completely.
Starting buprenorphine on 2012, it was said that we'd be maintained for a period of few months and then tapered off, but most patients actually requested higher and higher doses, which was allowed to them. I was actually among those who used it moderately since I've started with 2mg and raised the dosage for another 2mg twice during the 2012-2016 period, ending in 2016 by using 6mg daily. I know of guys who were prescribed was over the proposed maximum of 16mg, some up to 32.
Then, in 2016, I've got fed up with it. Buprenorphine made me unmotivated to have any form of social life. An opportunity came to move to another country and I used that moment to get off of it - and man that was an experience. I've depleted my stocks of the medication before I managed to taper off properly. I had withdrawal that lasted for a month and was way worse than any heroin withdrawal I had. I also didn't have access to anything I could use to ease it effectively (like tramadol, for instance), and my local psychiatrist happened to have went abroad to attend some convention. The ordeal ended once I've returned to my hometown after that month of agony and was given carbamazepine by my psychiatrist. I was surprised how well it worked because I didn't expect any improvement of my symptoms - but it instantly returned me to feeling completely normal.
What probably helped me in the next period to stay off those things was that I again moved abroad - a new environment that has no cues that would remind me of my former opiate use and no people from my "past life". All that time I've continued using naltrexone, just in case, having a reliable person to keep an eye that I don't start avoiding it.
As the time went by, I started developing anhedonia and lack of motivation, to the point that now I feel as if I'm not myself anymore. I also have problems with memory and attention that I think are caused by the two previously mentioned.
During the last year, I've tried paroxetine for few months, then tried stopping naltrexone. Paroxetine made things somewhat better at the beginning, but then returned to having no positive effect at all. Quitting naltrexone also didn't improve anything. I even did cocaine for a short period and stopped because I couldn't get properly high off it - only the first time I took it did I feel that characteristic high. The next 8 times I used it, which happened over a period of one month, felt like taking a very low quality amphetamine - I'd feel some pleasure for 30 minutes or so, and then start feeling agitation and unrest until the next dose - each following dose bringing less pleasure and more agitation.
I'm not sure what else could I try. I'm planning on checking my endocrine system, thyroid in particular, to see if maybe the cause is something else. My overall health is good, immune system is working well and bloodwork is also good, with cholesterol and triglycerides slightly elevated when I last checked. Still haven't re-checked, but I believe those two should also be back to normal, given that I adjusted my diet accordingly.
