New to Bluelight but I have been lurking here for five years or so and have always found the information very helpful, almost akin to what a discussion board on Erowid could have been like. As I warned, this is a lengthy post that not only covers my last 10 year struggle with opiates, but it also reflects on the state of treatment of Suboxone and Methadone patients in particular. Really this can be applicable for any addict, whether in recovery or not. If you want to skip this shit and see the basic question and guidance that I am asking for, scroll to the bottom. I really hope I didn't flub this and post in the wrong section, I figured forced titration goes under the heading of harm reduction, also my insights and experiences about maintenance centers could be considered harm reduction in that they may cause others to think a bit deeper about long term maintenance, with the challenges facing them, and the often unforeseen and very sudden repercussions.
So, I am about to turn 27 in a couple of weeks, and has been using everything I could get my filthy little paws on since they were 15. For me, the real trouble began with opiates around age 16, beginning with pills like most suburban kids, then moving up to street methadone pills for several years which is what really got me hooked, then the often unavoidable curse of IV H by 17. By age 19 I was completely out of control, almost died, had to leave college temporarily to go to a very expensive, supposedly reputable rehabilitation center: full 28 day inpatient followed by a few months in a half way house. Suffice to say, shortly after returning home, it only took me a few months to mess up and fall into old habits, specifically H, and as I was, at the time, ignorant to the ways of properly sanitizing and cleaning the entry site, I ended up with a bad case of Sepsis and was in the hospital for two full weeks, with a take home pick-line (a long term IV that can be used for weeks to months, a real pain in the ass). After nearly dying, again, I immediately got on Suboxone 8/2mg tablets, initially 3 times a day. I thinks/ it can be a wonder drug, however my rantings and ravings about how horribly and ignorantly over-prescribed that stuff is (in terms of dosage) will be for another day. I was on Suboxone successfully for nearly 4 years, however one day I lost his paper prescription, not the actual medication but just the paper. The doctor refused to write a new one for me and said that I had to wait 2 and a half weeks to see him again. While my dose was lower at the point of this occurrence, having to go cold turkey on a dose of 16mg after nearly 4 years of continuing treatment was a personal Hell that I was ill prepared for. I actually felt great for the first two or three days, I started thinking that this should have happened much sooner and that all was well. Day four shows up, and most can imagine what would happen next. Obviously there were PAWS symptoms
so bad, with the intestinal issues, constant sneezing, insomnia, horrible twitching/restless leg syndrome, etc. With no other options I regretfully got back on the Horse for six months and nearly destroyed everything in my life in the process. During this time, I also had to pass about *16 kidney stones over the span of two years*, the last of which required surgery and a stint. Not a fun combo for anyone, severely painful medical problems and very harsh Suboxone withdrawal could bring a giant down.
I finally got on Methadone, which in my opinion is worse than Suboxone, the withdrawals are just as bad, there is more stigma, and your chained to a damn clinic. After being on Methadone for almost 2 years, SWIM was cut from the clinic for being on a *legally prescribed* dosage of Clonazepam, 1mg 2x a day. They had notes from my Clonazepam prescriber saying he was okay with the combination. The Methadone clinic was fine with it until one day, then BAM I am out on the street, told that my best option was to immediately spend what could be up $20,000 and go to a detox center. Here in TN, the assumption is that if you take any maintenance drug, be it Suboxone or Methadone, on top of a benzo, your death is fucking IMMINENT. I realize that there are many circumstances where this is true, but more often than that the victim was either opiate or benzo naive, took 5-10 times the prescribed amount, or consumed other CNS depressants like alcohol as well. Regardless, at least a few people die here every so often from being on benzos and maintenance drugs so it has become very difficult for people who have legitimate problems to get the help they need without being judged and treated like criminals. I have lived in the South since birth, but I never experienced nor heard of a more opiophobic place than Tennessee. Granted, this state is one that would be roped into the "OC/Hillbilly Heroin" epidemic that is so often brougt up in the media, and as such, the state government keeps putting more and more pressure onto the clinics. At the end of the day though, no laws have been passed about Maintenance drugs and Benzodiazepines, it is up to the judgement of the prescribers, most of whom want to avoid liability, which I cannot fault them entirely for.
---After I was ejected from the Methadone clinic, I was up shit creek as they say, and was forced to check into a 7-day detox problem at a very unfriendly local mental institution. While there, they put me back onto Subutex, with the goal being that they would hold me over until I connected with a Suboxone provider that they recommended. Of course while there, they also dropped my Clonazepam to 1mg a day then .5mg a day for the last few days. At the time, I was 26, fairly healthy, and had never been diagnosed with blood pressure issues. As soon as they dropped the benzos, my bloodpressure shot up like a rocket, with the best results being 160/95, while some of the harsher results were in the 210/110 area. This tapering caused massive, unending migraines, and this tapering caused me have to be put on blood pressure medicine that is still taken to this day.
---Again the realization that this is long is fully there but please bear with. I left the hospital and resumed life to the fulllest with the help of the Sub provider, who, at the time of consultation, said he had no problem with me taking a low dosage of Clonazepam and Suboxone...the Sub Dr. even knew the Psychiatrist who prescribed the Clonazepam, who was actually a former Suboxone provider himself.
---Fast forward six or seven months. I have a really good job with benefits and all, I have been sober and happy and even found true love to the point of moving in and happily getting engaged. In other words, with the Suboxone therapy that acted as both a mild pain reliever and an effective opiate maintenance, in addition to the Clonazepam, I was living a very happy, social, moderately successful life, particularly for someone who had many hardships in the years prior (many of which were brought on by myself, no denial there).
Present day: I went to the Suboxone clinic for his monthly checkup, drug screen, some counseling, a "group therapy" session, all of that good stuff so that they can try and justify charging people $250+ for monthly consultations. When I gets to the group sessions, instead of the normal back and forther bantering bitching and occasional reminiscing about sobrierty and some forceful reminders of the 12 steps, a counselor of the institution tells us all about the big changes that are happening for our benefit. Seems that the head doctor, the one who originally gave me his stamp of approval for being on both Subs/Benzos, had purchased the ENTIRE facility and was seeing fit to make some changes. The biggest change is that there would be no allowing of Benzos, legal or not, in any form, for any reason. I asked the counseor how quickly this change of policy would go into effect and was given mainly vague answes. I could feel the hammer of doom circling around the facility. After having to give an observed drug urination test, which in and of itself was odd as I had failed no tests whilst there, I was eventually brought back into one of the prescribing physician assistant's office, an older lady who seemed to be new to the job. My current dosage was 8mg/2mg pills twice a day, so 60 a month. I was informed of the new rules about Benzos, however, NO ONE in the entire facility, not a single patient had any idea this was coming, so it is not like I knew this was going to happen and could have attempted a Benzo taper. They told me right there and then that because Clonazepam showed up on the test, they were going to cut the dosage in half from 16mg to 8mg a day and only supply a two week amount. In other words, I went from 60 pills a month to 15 for two weeks.
---What infuriates both myself and many other patients in this establishment is that there was no warning given to the patients. Had they been warned, they could have a started a much safer detox, or started searching for other clinics. What they did however, was institute a new rule and then enforce it the same day without any notice. When I pleaded that this would have an uprecedented affect on both my personal and professional life, they responded with "Well buddy you can go to detox, get off the benzos, and come back in two weeks. If the Benzo levels are 0.00000 then help will be available". The hell if im about to go through Benzo withdrawl again when it A.) causes horrible panic attacks, B.) would cause my blood pressure to rise to dangerous levels, and of course C.) Hospital administered Benzo detoxes are a joke around here. They load you up with phenobarbitol for 12 hours then let you go cold turkey. I am not trying to die from Benzo withdrawal!
***** For the tl;dr crowd: I complained a lot, then asked for advice on getting off suboxone. So, if I am currently taking between 4-8mg of suboxone a day, and has about 40-50mg left(between 5 and 6 pills), what would be the most painless way to titrate down as quickly, but effectively, as possible? My goal is to take just 4mg today, then try 2mg a day for about a week - that would be 18mg or roughly under half of the amount left. From there, should I just try to cut down to 1mg a day for the next two weeks? That would be 32mg in three weeks, which will probably suck pretty badly then. I only have experience with getting off of Suboxone cold turkey, obviously against my wishes. I know there are other threads about Suboxone and titration, but I also really wanted to share my story about the detiorating treatment and conditions of suboxone and other maintenance patients. It is disgraceful to say the least. Any insight would be much appreciated!*****
***Fixed all of the SWIM bullshit, took me twenty minutes. Forgot that they didn't do that here like they do on some other drug forums. My apologies, I must have typed/deleted that word 100 times. I also realize this thread reads long a fairly long bitch-fest-narrative but I had to get it out, feeling like you have been mistreated by the medical community is a really shitty feeling.***
So, I am about to turn 27 in a couple of weeks, and has been using everything I could get my filthy little paws on since they were 15. For me, the real trouble began with opiates around age 16, beginning with pills like most suburban kids, then moving up to street methadone pills for several years which is what really got me hooked, then the often unavoidable curse of IV H by 17. By age 19 I was completely out of control, almost died, had to leave college temporarily to go to a very expensive, supposedly reputable rehabilitation center: full 28 day inpatient followed by a few months in a half way house. Suffice to say, shortly after returning home, it only took me a few months to mess up and fall into old habits, specifically H, and as I was, at the time, ignorant to the ways of properly sanitizing and cleaning the entry site, I ended up with a bad case of Sepsis and was in the hospital for two full weeks, with a take home pick-line (a long term IV that can be used for weeks to months, a real pain in the ass). After nearly dying, again, I immediately got on Suboxone 8/2mg tablets, initially 3 times a day. I thinks/ it can be a wonder drug, however my rantings and ravings about how horribly and ignorantly over-prescribed that stuff is (in terms of dosage) will be for another day. I was on Suboxone successfully for nearly 4 years, however one day I lost his paper prescription, not the actual medication but just the paper. The doctor refused to write a new one for me and said that I had to wait 2 and a half weeks to see him again. While my dose was lower at the point of this occurrence, having to go cold turkey on a dose of 16mg after nearly 4 years of continuing treatment was a personal Hell that I was ill prepared for. I actually felt great for the first two or three days, I started thinking that this should have happened much sooner and that all was well. Day four shows up, and most can imagine what would happen next. Obviously there were PAWS symptoms
so bad, with the intestinal issues, constant sneezing, insomnia, horrible twitching/restless leg syndrome, etc. With no other options I regretfully got back on the Horse for six months and nearly destroyed everything in my life in the process. During this time, I also had to pass about *16 kidney stones over the span of two years*, the last of which required surgery and a stint. Not a fun combo for anyone, severely painful medical problems and very harsh Suboxone withdrawal could bring a giant down.
I finally got on Methadone, which in my opinion is worse than Suboxone, the withdrawals are just as bad, there is more stigma, and your chained to a damn clinic. After being on Methadone for almost 2 years, SWIM was cut from the clinic for being on a *legally prescribed* dosage of Clonazepam, 1mg 2x a day. They had notes from my Clonazepam prescriber saying he was okay with the combination. The Methadone clinic was fine with it until one day, then BAM I am out on the street, told that my best option was to immediately spend what could be up $20,000 and go to a detox center. Here in TN, the assumption is that if you take any maintenance drug, be it Suboxone or Methadone, on top of a benzo, your death is fucking IMMINENT. I realize that there are many circumstances where this is true, but more often than that the victim was either opiate or benzo naive, took 5-10 times the prescribed amount, or consumed other CNS depressants like alcohol as well. Regardless, at least a few people die here every so often from being on benzos and maintenance drugs so it has become very difficult for people who have legitimate problems to get the help they need without being judged and treated like criminals. I have lived in the South since birth, but I never experienced nor heard of a more opiophobic place than Tennessee. Granted, this state is one that would be roped into the "OC/Hillbilly Heroin" epidemic that is so often brougt up in the media, and as such, the state government keeps putting more and more pressure onto the clinics. At the end of the day though, no laws have been passed about Maintenance drugs and Benzodiazepines, it is up to the judgement of the prescribers, most of whom want to avoid liability, which I cannot fault them entirely for.
---After I was ejected from the Methadone clinic, I was up shit creek as they say, and was forced to check into a 7-day detox problem at a very unfriendly local mental institution. While there, they put me back onto Subutex, with the goal being that they would hold me over until I connected with a Suboxone provider that they recommended. Of course while there, they also dropped my Clonazepam to 1mg a day then .5mg a day for the last few days. At the time, I was 26, fairly healthy, and had never been diagnosed with blood pressure issues. As soon as they dropped the benzos, my bloodpressure shot up like a rocket, with the best results being 160/95, while some of the harsher results were in the 210/110 area. This tapering caused massive, unending migraines, and this tapering caused me have to be put on blood pressure medicine that is still taken to this day.
---Again the realization that this is long is fully there but please bear with. I left the hospital and resumed life to the fulllest with the help of the Sub provider, who, at the time of consultation, said he had no problem with me taking a low dosage of Clonazepam and Suboxone...the Sub Dr. even knew the Psychiatrist who prescribed the Clonazepam, who was actually a former Suboxone provider himself.
---Fast forward six or seven months. I have a really good job with benefits and all, I have been sober and happy and even found true love to the point of moving in and happily getting engaged. In other words, with the Suboxone therapy that acted as both a mild pain reliever and an effective opiate maintenance, in addition to the Clonazepam, I was living a very happy, social, moderately successful life, particularly for someone who had many hardships in the years prior (many of which were brought on by myself, no denial there).
Present day: I went to the Suboxone clinic for his monthly checkup, drug screen, some counseling, a "group therapy" session, all of that good stuff so that they can try and justify charging people $250+ for monthly consultations. When I gets to the group sessions, instead of the normal back and forther bantering bitching and occasional reminiscing about sobrierty and some forceful reminders of the 12 steps, a counselor of the institution tells us all about the big changes that are happening for our benefit. Seems that the head doctor, the one who originally gave me his stamp of approval for being on both Subs/Benzos, had purchased the ENTIRE facility and was seeing fit to make some changes. The biggest change is that there would be no allowing of Benzos, legal or not, in any form, for any reason. I asked the counseor how quickly this change of policy would go into effect and was given mainly vague answes. I could feel the hammer of doom circling around the facility. After having to give an observed drug urination test, which in and of itself was odd as I had failed no tests whilst there, I was eventually brought back into one of the prescribing physician assistant's office, an older lady who seemed to be new to the job. My current dosage was 8mg/2mg pills twice a day, so 60 a month. I was informed of the new rules about Benzos, however, NO ONE in the entire facility, not a single patient had any idea this was coming, so it is not like I knew this was going to happen and could have attempted a Benzo taper. They told me right there and then that because Clonazepam showed up on the test, they were going to cut the dosage in half from 16mg to 8mg a day and only supply a two week amount. In other words, I went from 60 pills a month to 15 for two weeks.
---What infuriates both myself and many other patients in this establishment is that there was no warning given to the patients. Had they been warned, they could have a started a much safer detox, or started searching for other clinics. What they did however, was institute a new rule and then enforce it the same day without any notice. When I pleaded that this would have an uprecedented affect on both my personal and professional life, they responded with "Well buddy you can go to detox, get off the benzos, and come back in two weeks. If the Benzo levels are 0.00000 then help will be available". The hell if im about to go through Benzo withdrawl again when it A.) causes horrible panic attacks, B.) would cause my blood pressure to rise to dangerous levels, and of course C.) Hospital administered Benzo detoxes are a joke around here. They load you up with phenobarbitol for 12 hours then let you go cold turkey. I am not trying to die from Benzo withdrawal!
***** For the tl;dr crowd: I complained a lot, then asked for advice on getting off suboxone. So, if I am currently taking between 4-8mg of suboxone a day, and has about 40-50mg left(between 5 and 6 pills), what would be the most painless way to titrate down as quickly, but effectively, as possible? My goal is to take just 4mg today, then try 2mg a day for about a week - that would be 18mg or roughly under half of the amount left. From there, should I just try to cut down to 1mg a day for the next two weeks? That would be 32mg in three weeks, which will probably suck pretty badly then. I only have experience with getting off of Suboxone cold turkey, obviously against my wishes. I know there are other threads about Suboxone and titration, but I also really wanted to share my story about the detiorating treatment and conditions of suboxone and other maintenance patients. It is disgraceful to say the least. Any insight would be much appreciated!*****
***Fixed all of the SWIM bullshit, took me twenty minutes. Forgot that they didn't do that here like they do on some other drug forums. My apologies, I must have typed/deleted that word 100 times. I also realize this thread reads long a fairly long bitch-fest-narrative but I had to get it out, feeling like you have been mistreated by the medical community is a really shitty feeling.***
Last edited:
