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What are the advantages and drawbacks to living in recovery on opiat maintenance.

dopemegently

dopemegently

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Aug 22, 2013
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Here's the thing with me: I used to be an injecting heroin addict, and a hardcore opiate addict. I started on bupe replacement therapy
8 years ago, and have been on it ever since. (12 mgs per day). I know I'm on an opiate drug, and that I'm not "clean". But the bupe doesn't make me high: it makes me feel normal, and my mind is clear. I attended NA meetings a couple years ago, but I felt out of place in an abstinence-based program, in fact my sponsor told me I was sick and should stop immediately. The thing is I don't feel ready to quit; I worry that without the bupes blocking effect, I will feel the urge to use heroin. Also, I have severe dependency issues,as all addicts do. My drug worker said they want to get me off it, and since then I've been obsessing over the WD symptoms and procuring drugs to relieve said symptoms, I have also begun experimenting with recreational drugs again, and can feel myself sliding torwards "druggy mode".

My key worker tells me I'm stable and doing well; I'm not sure about that. I'm not living a normal life, in fact I am stuck in a rut; I have become completely isolated, and this has led to feelings of despair and social anxiety. What I'm saying is, am I really in recovery? Will I only be able to move forward if I'm completely abstinent? I feel the thing that's holding me back is my isolation. I could really use help to combat this: I only get one hour of basic counselling per month, and it's just not helping me.

Edit: sorry if this thread is out of place; I wasn't sure to post it here or the dark side section.
 
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I wouldn't worry about what others think about using bupe and being clean, as long as you are living a productive life. But if you are using bupe and still acting like a druggy then I wouldn't consider that clean.
 
Thanks for the really quick reply. Yeah, I don't feel clean at all and I'm sure as hell not leading a productive life. I've vowed to not buy any mail order drugs; (I've been buying kratom, phenibut, and loperamide for WD symptoms, but have been using phenibut quite a lot. I've given my cash to somebody I trust so I can't buy the stuff anymore. I've started taking exercise and I'm determined to dig myself out of this rut, but it's difficult, I won't lie.
 
Hey mate, same story here in terms of opiate addiction followed by bupe maintenance for several years. I'm somewhere around 6 weeks off the bupe and feeling better, but let me rewind this story.. I too felt like I was normal and functioning on bupe, however I one day (well more like a couple months) I woke up thinking about the long term sustainability of maintenance drugs and their effect on me as a human being. This led me to quit, which also coincided with my decision, or rather desire, to enlist in the Navy. Maybe I just needed a reason, maybe you do too, maybe you already have one. Whatever it is, it has to be a strong reason or you'll have a hard time getting past the acute phase.

If nothing else and you decide to continue maintenance you should at least cut down your dose to the lowest effective level. You'll thank me later if you ever do decide to put down the bupe. Also use this time while on the bupe to get your strength UP, as much as possible. I would advise against kratom while in acutes, you'll only prolong the already long 7-14 day episode. I used kratom about 3 weeks after the acutes but quickly found it just another opiate with opiate withdrawals so I quit after a few days. I highly recommend putting the phenibut down now while it still has its magic - you will love this stuff after PAWS sets in. I just finished a week on it and I'm cycling off it this week. Unfortunately it too is yet another drug that causes (fairly rapid) physical dependence thus are prone to similar pitfalls.

I'll add to this if I think of anything else. Try to stockpile some quetiapine or non-narcotic sleep aid. Be prepared to not work, sleep, see family, go out etc for a week. But I will tell you that what lies beyond the other side of 2 weeks is something that you will cause you to literally cry when you experience it. I had no idea how suppressed my body and mind had become while on bupe. I'm a 26 year old nothing phases me kind of guy but I'll tell ya what mate, I will never ever forget that feeling of my old self returning like I had been hit with a defibrillator of natural euphoria.

Until you're ready to put the opiates behind you though you gotta stick to maintenance and therapy if possible. You gotta be ready with a purpose.

TO answer your question about whether you're clean, that is for you and you alone to decide. It is not the part of society, myself, the forum, AA, NA, your doctor, your dad, the neighbors or anyone else to label you. If you know in your heart that you are on bupe in order to assist you in leading a productive life and to keep your matters in order then you can 110% call yourself clean. Just know that there are different levels and degrees of sobriety/abstinence that others will label you. I'm sure because I used kratom 3 weeks after quitting bupe there would be someone out there that'd say I haven't been clean and blah blah blah.. screw those people.

EDIT: I want to clarify that kratom is not useless by any stretch - it is very useful as a method of taper if that's what you plan to do with it. Just realise that you cannot use it consistently without some form of dependence and resulting withdrawal.
 
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Some great advice there. It's funny, I am actualy considering a career in the navy as well. This is my "light at the end of the tunnel". I'm 28 and feel my time is running out; the thought of being shackled to bupe for life is pretty scary.(it would rule out a career in the navy, for one. The only benefits I see in bupe is that I wont WD and I can't use. I dont think this is enough to make me commit to it for life; I find that a depressing thought. So, I will soon be beginning my taper, it will be a slow one, and I have kratom and loperamide to help me. And I'll be careful to avoid dependence; I'm using them as therapeutic drugs only.

What you described is the thing I've been missing for a long time: I also feel supressed, i don't feel myself again. It's extremely reassuring to know the detox process will not be as painful as I feared it would be.

Thanks again for your great advice, mate.
 
Here's how I look at it. I haven't gotten high in a long while. I do take bupe (12mgs) and I occasionally take a Valium for panic attacks. I don't get high. I can have a few beers without going over the edge. However, I wouldn't go anywhere near an opiate.

I am not engaging in harmful behaviors, I am not engaging in the habits that plagued me during my addiction, and I do go to a 12 step meeting 3 to 4 times a week.

In my mind I am sober, but I am not abstinent. Opinions on this vary greatly and I don't share the fact that I will rarely have a glass of champagne or wine with my wife at dinner with members of my AA group because it would be met with a lot of resistance. The group helps me with issues surrounding addiction and life, but some things I keep private.

You sound clean to me. You're stable, you're happy, you're working through it. Perhaps you could talk to a therapist or go to a meeting and just omit the fact that you take medication. They can be very helpful.
 
Thanks mate, you also sound clean to me. It's all in the mindset, isn't it? If you're not stuck in that "have to get messed up now!" thinking, then you're obviously past the worst of it. The meetings can have a lot of positive aspects ie you get a support network of recovery focused people. So, like you, I will also keep my subixone use under my hat, and just take the positives from it.
Right now, I'm looking into CBT therapy.
 
don"t quit the subs when you have such a good effect from them.
I'm in the same boat,16mg for 5 years.
it's 100%worth it to be alive and free.
you are clean.dont worry.
 
Cheers mate, that really means a lot to me. It's true: the suboxone has done me a great deal of good; I could be in a terrible position. I suppose what this really boils down to is a residual guilt from attending an abstinence-based treatment centre.(They left me under no illusions....) but it's crazy to let shit like that derail you. In fact I remember being on the verge of using crack, and thinking "What difference would it make?". I managed to pull back at the last minute (the pipe was literaly in my hand).
 
When I finally got off methadone and had went through the acutes and had a little sobriety time I was amazed at how clear my mind was.. Then when the opiat receptors finally shut down around month five I was astonished at how clear my mind suddenly became. I had been living in a drug haze for so long that I had no idea what a drug free mind feels like. I know now that not getting high or being stabilized at a certain effect of a drug is good but there is a major difference between being stabilized on a drug and being stabilized off drugs. Anyone who, Like I did, thinks they feel normal on a maintenance program no longer knows what its like to feel normal.. and I say this with no judgment or opinion on what is right.. what right is what provides the highest quality of life for an addict.. but no BS, from my own personal experience of being on a maintenance program, your mind and life are so different from where we were on herion, but the change after a half year or so of being off the opiates and daily hard drug abuse.. the change is profound.. I would never have guessed that I was living in that much of a fog.

So I guess DMG is that I guess who give a rats ass about the age old debate about sobriety.. are you going to experience life and your mind on suboxone that you would off of it.. no.. is this such an profound difference thats is worth relapsing over and over to try and get.. no of course not.. is it such a big difference that its worth doing the long detox and withdrawal from the maintenance.. absolutely worth every miserable minute i spent in withdraws fivefold already already.
 
^ Yea I agree. I do think that many of us need a few months on drugs like suboxone though in order to help us transition into life without our DOC. If you don't need it then don't do it. I can tell a big difference between the two. I was actually getting a little pissed off at my outpatient group because I was getting shit about relapsing twice in the beginning (just 1 day of use a week apart), yet I was the only one there for opiates that was not on suboxone so to me it was so much harder but I was willing to deal with the struggle to be completely off of everything. If I were on just 2mg of bupe I wouldn't have a problem staying away from anything, but I'm trying the all natural way first. It's whatever works though, I've gone the bupe route before but at such a high dose it causes a lot of problems in the long run.
 
Hey guy's I just shot those last few posts over to this thread as I felt that is the location to continue the never ending debate on what is clean and sober. I also changed the name of this thread to something I felt carried the OP's idea better. Please PM me if anyone needs anything in regards to this action or would like the name of the thread changed.

> What do you consider to be, 'clean and sober'? <
 
No, it was a great idea, and far more appropriate. (My original title was appalling).

About what you were saying about your mind being clear: that's what I want. You know that feeling when you're "high on life?",well that's what I badly lack and I have to say, it did more for me than any drug. I just try not to let the fact I havn't had that for a decade get to me. (I admit: sometimes I feel despair that I wasted a great part of my youth by missing all of the great things life can offer).

So with this in mind, I will soon be starting my suboxone taper. I've made an appointment with my doctor to discuss this. Some times I feel terror at the thought of coming off, sometimes I feel excited; and I have BL to thank for my new-found decision I've been fretting over for so many years. It's when I hear people talk of how clear headed they are, that's inspired me, so thanks neversickanymore
 
Glad to be of some assistance=D

In my opinion when you get off the maintenance and then give your brain time to adjust back to base line you will experience what you are looking for. You can do this if you want.. its sucks for a little while and then it get good quick if you are willing and put the necessary work in to change your thinking and your life and are willing to go back and heal your self from the wounds of your addiction and search and fix the root or the original causes of the addiction.

Its an amazing road to travel.. and when you are done with even with the first part you will find you are stronger than you have ever imagined.
 
As far as i am concerned being physically dependent on a drug, like in your case buprenorphine does not make you an "addict" by how i (and most of the medical community i believe) would define the word.

If you do not feel ready to come off the bupe it would be stupid to do so for the wrong reasons ie. the opinion of one other person who does not know what you are going through or because it does not mean you are "clean" in the eyes of random people.

What is more important for you at this time IMO is to pin point the reasons why you are getting back into desire for rec. drug use, and why you are isolating yourself, i think that the more you isolate yourself, the social anxiety will increase, like exposure therapy backwards, if you see what i mean.

It would seem like you need more intensive therapy but this can be difficult for a number of reasons, mostly financial, or finding a "compatible" therapist amongst other things.
 
I completely agree; you speak a lot of sense. The isolation really comes from social anxiety, so it's kind of a vicious circle in terms of limiting my options. Really effective therapy is invaluable to helping with these dependency issues, but of course I live in a state-subsidised healthcare system, which is great in itself, but funding for specialized therapy like that is limited. I've looked into going private, but I simply can't afford it. I'm crossing my fingers for residential treatment, but I don't have much hope in getting it.

In pinpointing the reason I'm feeling drawn back towards drugs, It's really about the isolation and missing out on a normal life. I'm sure this is the main reason, although as I said it's also about ensuring a painless detox, and that's why it all started. Thanks for the feedback, phatass, you cut to the heart of the matter.
 
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