Misc Treatment for Opiate Addiction When Also Addicted to a Benzo

[RTrain]

Hey everyone, what's happening BL'ers?

I was wondering if anyone has experience working with a suboxone Dr when they have a polysubstance addiction, particularly being addicted to both an opiate and a benzo(NOTE: both are not prescribed)? In my case its fentanyl and Xanax.

I almost never take the Xanax in doses of more than 1 mg(2mg/day, 1 in AM, 1/2 afternoon and evening) so it basically does nothing except control my anxiety. Actually the only time I really will do more is when I need it, when I am having a severe anxiety attack(I have one appx 1-2 times per month).

Also, what about methadone clinics? How do they approach a person who is seeking methadone treatment but is also addicted to Xanax (non-prescribed)?

 

[namnoc16]

In my are the clinics(meth or subs) pretty much have a zero tolerance for any other illicit drugs and if you pop hot for drugs that aren't opiates they will kick you out fast. If your on methadone and keep popping dirty for opiates(in the beginning of treatment) they will increase your dose because they see continued use as a sign your maintenance dose isn't enough. Benzos combined with opiates(I'm sure you know) can be lethal and they won't take the risk.

 

[RTrain]

So basically they tell you to go screw in this situation? Its almost impossible to come off both at the same time (especially since benzos should be tapered off very slowly) and I think its clearly less risky to be taking a set dose of Suboxone and Xanax than taking the Xanax with full agonist opiate in various dosages. Also, I could drink booze to my hearts content and not pop dirty for anything, but people hear the word benzo and freak out. If you are tolerant to them and taking them at your tolerable dose there is no risk taking them with Subs, I kind of understand the methadone clinics not wanting it because they don't know what you can handle and its much stronger. But, anyone needing Subs should be much safer taking benzos with the Subs than their full agonist DOC.

This is the typical situation where patients can't get appropriate help because DRs need to cover their asses. I think its an odd conundrum and a detriment to helping addicts recover that the worse someone's addiction is, the less help they are given. So much preaching about the need to help the addicted, but then turn people away and not find a way to work with someone who needs the help. Most of them really have no clue. Just continue to prescribe 8 mg a day to people on 5-10 Vicodin or Percocet a day and put them on a
stronger and much harder to get off opioid like buprenorphine.

In my are the clinics(meth or subs) pretty much have a zero tolerance for any other illicit drugs and if you pop hot for drugs that aren't opiates they will kick you out fast. If your on methadone and keep popping dirty for opiates(in the beginning of treatment) they will increase your dose because they see continued use as a sign your maintenance dose isn't enough. Benzos combined with opiates(I'm sure you know) can be lethal and they won't take the risk.

In your what? country? I'm in the US, Sub isn't dispensed in clinics for the most part just DRs offices that specialize in it (at least for now, hopefully it doesn't change). But I think most DRs are scared of people on benzos. I don't know what would happen if someone was to be upfront about it, let them know it is something they also want to deal with.

 

[namnoc16]

I live in U.S.(about an hour from Philly) and yes many times people get their subs from sub docs but they can only treat a certain number of patients at a time so a lot of the methadone clinics also script out subs.

It's been 11 years since I was on methadone and they and just started getting stricter. They used to allow you dirty urines you just couldn't get take homes but eventually they had a 3 strikes policy where 3 dirtys and your out.

It's been 6 years since I was last on suboxone and I came in the office of a clinic to get my script for the month,they wanted a urine, I pissed hot for cocaine ,and that was it . One dirty and I was out on my ass!