Opiate Dependence, Cold Turkey Withdrawal & Suboxone – Page 2 of 2

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Hitting Rock Bottom, Recovering & Hitting Rock Bottom Again

Rock bottom is a tough place to be, but on the other hand it can be a blessing because that is what it takes for some people to take action.  The truth of the matter is that a typical addict will hit rock bottom several times possibly as many as half a dozen before hitting that point where they have a chance of recovering. Some people do it their first time, for me it took about three times.

The first time I ended up in the hospital with complications related to high doses of opiates and it was enough to put a scare into me.  I put together a taper plan and followed it to the bet of my ability.  I actually almost made it to the end when I relapsed and within two weeks was right back where I started.

 

Real Rock Bottom – Cold Turkey Withdrawal & Counseling

My second crash to rock-bottom was much worse, my family intervened and they all told me how much I was hurting them and how they could see how I was hurting myself.  Getting my family involved was crushing and had me contemplating suicide as a very possible way to escape.   I was angry at my family and friends for not believing I could quit on my own and I proved them wrong by completing a cold-turkey withdrawal over about a ten day period. I gave it everything I had and barely made it; I can remember somewhere around day 4, 5 & 6 thinking I couldn’t take it anymore and was about to ask to be taken to the ER.  I held strong and pulled through on my own.   I swore to never go through that again and I attended NA meetings once or twice a week.

At this point I didn’t really believe *I* belonged in those meetings.  I still felt that I was “above” them.  This was far from the truth.

Suboxone Treatment & Counseling

But once an addict always an addict, I relapsed a few months later after I forgot about how bad things were.  This time I caught the mistake myself and took action on it myself.  I searched the yellow pages for Suboxone Clinics.  Let me start off by saying this, if Oxycodone is the devil, then Suboxone is the devils’ sister.  But if you go into a Suboxone treatment with a strong respect for it, you have a good chance at succeeding.

I make no money for talking positive or negative about Suboxone.  I can think of a lot of negative things to say about it, but I can say that it very well may have saved my life and I pray that the government never takes this amazing drug off the market.  If anything needs to be done, it is that doctors need a better education about Suboxone, the persons taking it know much more than those prescribing.

Lessons Learned in the Opiate Addiction

I’ve learned a lot over the years about opiate addiction, and various methods of recovery.  If one of my family members were on the same path as I was; I would definitely recommend he Suboxone Treatment, but I’d also make sure they had a very strong respect for Suboxone and how powerful it really is.  You are trading one opiate for another, but Suboxone has a very long half life and offers other advantages that basic opiates don’t offer.

I hope you enjoyed my story, and I hope that it compels you to share yours.

Sincerely,

SuboGuy

 

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Suboxone Here To Help – $0 Copay Card on Suboxone Film

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Suboxone Here to Help Manufacturer Coupons & Printable Coupons

The manufacturer of Suboxone Film, Reckitt Benckiser currently has two money saving programs for assisting patients who are taking Suboxone.  They also have the “Here to Help” program to help those who are taking Suboxone with any treatment related questions or problems.

  1. Suboxone Film Coupon, Pay $0 Copay and Save up to $50 per month. (Reckitt Benckiser Patient Assistance) (offer extended)
  2. SuboxoneHere to Help” Guided Support for your Suboxone Sublingual Film Treatment
  3. Suboxone Copay Reduction Offer – Free Printable Coupon – Save up to 75% Retail Prices

 

1. Here to Help Suboxone $0 Copay Card to Save Up To $50 Monthly With Each Refill

Suboxone $0 Copay Card
Suboxone $0 Copay Card

$0 copay for SUBOXONE Film has been extended until 6/30/13.

For more information, visit SuboxoneFilmCopay.com

To print your $0 Copay Card, visit http://sfilm2.com/coupon.aspx

Specifics of the program:

  • copay card covers the portion that your health insurance does not pay (up to $50 per month) for SUBOXONE Film.  Instead of paying out-of-pocket amounts for Suboxone, you can use the $0 Copay card to reduce copay amounts by up to $50 a month.
  • Makes Suboxone Film more affordable than the SUBOXONE® (buprenorphine and naloxone) sublingual tablets (CIII)*
  • SUBOXONE Film is equally effective as the tablet with many benefits.

Suboxone Film is Better Than Suboxone Tablets

  • Faster to dissolve than SUBOXONE® (buprenorphine and naloxone) sublingual tablets
  • Better taste than the tablets (more than 71% of patients scored the taste as neutral or better)
  • Each dose is individually wrapped in compact unit-dose pouches that are child-resistant and easy to carry
  • Once-daily dosing like the Suboxone tablet
  • Clinically interchangeable with SUBOXONE Tablet, so your doctor can easily transition you. Your doctor will monitor your progress to ensure your dose of SUBOXONE Film is appropriate.

Present this offer each time you fill your SUBOXONE Film prescription. The last day this offer will be valid is June 30, 2013

2. Reckitt Benckiser Patient Assistance - Here to Help Program

Here To Help ProgramThe Here to Help® Program was created to help motivate, encourage, and equip you to manage your daily experience while in treatment for opioid dependence.

Visit the Here to Help website by visiting here.

Think you might be opioid dependent?

Take this quiz.

Ready for treatment?

This can help you find a doctor certified to treat opioid dependence in the privacy of his or her office. You can also call 1-866-973-HERE(4373) for help connecting to a doctor in your area.

Want to know what treatment is like with SUBOXONE Film?

This can help you understand the stages of treatment.

3. Printable Coupon For Suboxone – Up to 75% Off Retail Prices

Printable Coupon for Suboxone

 

For more information on this program visit here.

Save up to 75% off Retail Prices for Suboxone.

 

  • Discount program for drugs.
  • Works like an AAA card that will get you discounts on hotels.
  • Ideal for people with no drug coverage, self employed.
  • Donut Hole Seniors
  • Use the coupon at most large pharmacies such as CVS or Walgreens
  • Not to be combined with insurance or other offers.
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3 Month Suboxone Addiction – Help to Quit

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Suboxone Addiction – Help to Quit

The subject of this blog post is taken from another that I found via a web-search for Suboxone Addiction.  I am making a post about this question because it is a common one that I get asked here and I believe it is more of a problem than we know about– and the main reason I started this website was to help others with this problem.

I will post quotes from the full blog post titled 3 Month Suboxone Addiction – Help to Quit found here.

This post also discusses the authors real-world taper off of Suboxone using a very gradual taper which is illustrated using the self-made Taper Charting Tool

Have Been Addicted to Roxycodone For Almost 2 Years

I have been an addict to Roxycodone for almost 2 years, I have attempted to quit multiple times using the cold turkey method first, which helped me mentally and physically because it gave me a new aspect on life. However, I only stayed clean for maybe a month and slipped back in the hole.

This is a common start to the story, an addiction to a powerful opiate like Ocycodone and then getting some form of help which leads to Suboxone Treatment for Opiate Addiction.

Used Suboxone for Opioid Addiction thinking it is Safer and/or Better

After some talk with my friends, they persuade me to not use Methadone because there is a great chance of becoming addicted, so instead they told me Suboxone would never get me addicted because it never gets you high.

Again, this is so common and I think so far the original poster is taking the right path.  I think Suboxone Treatment saves a lot of lives and helps people break free from the strong opiate (oxycodone, etc.) addiction that destroys lives but in my humble opinion it leads to people dependent on Suboxone or who find it very hard to break free from the Suboxone.

Failed Quitting Suboxone – Tried Quitting Suboxone Unsuccessfully

The first few times trying to quit off Suboxone I failed but eventually this last time I successfully quit the “blues”. I took the suggested dose of suboxone 2mg 2x a day and was doing fine, with mild w/d effects. Every once in a while I would do an extra 2mg when I would get depressed or start craving the “blues”…

There are so many variations to this persons; story but the basic story is the same, the person broke free from the Oxycodone stronghold but is now dealing with a less-destructive but equally as challenging problem.  Quitting Suboxone is very difficult and not many doctors admit this up front– I’m convinced that many doctors don’t believe it much like psychiatrist didn’t believe in SSRI withdrawal.  It took years before psychiatrists’ and drug manufactures (and FDA) believed in SSRI withdrawal or SSRI discontinuation syndrome but now it is widely accepted.

Suboxone is Very Strong Medicine – Much Stronger Than Doctors Seem To Believe

My theory is that doctors do not realize how strong Suboxone is and they underestimate how a 2mg dose can cause an addiction.  I recall certain doctors saying that anyone noticing withdrawal from a 1mg Suboxone dose is not really experiencing withdrawal and it is “all in their mind”.

First of all – isn’t withdrawal always “in our mind”?  That is a rhetorical question.

Want To Quit Suboxone But Cannot

The last part of the post that I’ll talk about is the part where the original poster talk about how they believe it is time to quit and they feel that being on Suboxone is not being “really clean”.

This is a hotly debatable topic, are you really clean when on Suboxone or not?

I used to say “Yes” but am leaning more towards “No’ after a few years experience and/or exposure to the medication through myself or friends.  I think an addict should be proud of breaking free of Oxycodones’ and getting on a Suboxone treatment plan by a Suboxone doctor but I also think that the addict needs to remember they are still dependent.

I have noticed recently I have been seeing signs of addiction towards the Suboxone; things such as getting depressed, feeling tired all the time unless I do another dose of suboxone, and craving doses a lot. I think it is time to give up Suboxone and getting completely clean. I am a student in College and am holding a job, and I have made it this far without being clean because I don’t ever have the time to quit and deal with w/d.

The original poster said their dose was currently at 8mg daily, which in my opinion is pretty high, much higher than probably needed but I am not a doctor and everyone is different.  I personally feel that any addict after they have gone a month without Oxycodones can wean down to 4mg daily without much physical discomfort.

I also believe it is not that difficult to wean down to 1mg Suboxone daily over a period of a month, even from an Oxycodone addiction from as much as 120 – 240mg daily.

My personal experience is that you need a front-loaded dose of Suboxone, something in the neighborhood of 8mg – 24mg daily for a few days and can then taper down to 8mg daily for the first week after.  Depending on how strong of an addiction you came from it shouldn’t be hard to taper to 1mg of Suboxone daily within 30 days.

Tapering To 1mg Suboxone Daily is Not That Hard

I have found that going below 1mg of Suboxone the point where things start becoming challenging. But again this information is being provided for entertainment purposes only and all dose amounts should be provided by your doctor and followed exactly.

The original poster also said:

My daily routine:

- I wake up and immediately insufflate 2mg, I go to my job or school and last 4-5 hours later when I insufflate another 2mg, then in 3 hours I insufflate another 2mg. Recently, I insufflate another 2mg in another 2 hours.

I have to say that this is a bad idea.  You should not snort Suboxone for one it is not an efficient means of treatment and wastes the medication not to mention you don’t know what the side-effects are from taking medication that way.  There is no recreational value to snorting Suboxone, generally speaking from what I have seen.  There is little to no recreational value in Suboxone period from what I’ve seen and experienced.

How To Quit Suboxone For Good – Long, Slow, Gradual Tapering

I believe that tapering from any addictive medication is the way to go IF you can do it. Tapering from a highly addictive substance like Oxycodone is nearly impossible because it is so addictive and because it has such a short half-life.

Half-life basically means the number of hours before one half the useful part of the medication is removed from your body. Oxycodone has a very short half life in the neighborhood of six hours so if you rail 30mg of Oxycodone at noon half that is gone by 6pm and nearly all of it gone within 24 hours.

Suboxone Has a Very Long Half Life

Suboxone has a super long half-life compared to Oxycodone, approximately 37 hours and it is different for everyone, could be as high as 60 hours in some people on other medications with over-worked liver.  The difference between a medication having a 6 hour half-life and a 37 hour half-life is night-and-day.

Suboxone Half-Life Night-and-Day Difference Compared to Oxycodone

You can check out the Half-Life Elimination Charting Tool on this site to experiment with how long medications stay in your system based on half-life.  The tool was developed by a programmer and is for entertainment purposes only but it will give you an idea of the differences between a 6 vs 37 hour half-life medicine.

The tool works for any medicine that has a linear half-life as long as you use the same unit of measure for example use dose in milligrams, grams, micro-grams,  oz, etc., it doesn’t matter as long as the dose is numeric and consistent.  If you took 1.2 grams of a medicine one day and 200mg the next day just enter 1,200 milligrams and then 200mg using the common denominator of “milligrams”.

Suboxone Half-Life Elimination Tool – Suboxone Tapering Tool

http://www.subotex.com/SuboxoneTaperChart.html

** For educational purposes only I am not a doctor – I am a computer programmer who used basic half-life elimination formulas to develop the tool.

If you open the tool, you will need to have Microsoft Silverlight on your computer.  You may already have Silverlight, but if not you will be prompted to install it.  You can run the tool on non-Microsoft computers such as Mac or Linux.

 

The Real Secret To Quitting Suboxone

I think that a very long, shallow taper is the way to get off Suboxone with little or no discomfort.  When I say long, I am thinking of at least one month to go from 1mg daily to nothing.  Getting to 1mg daily of Suboxone is a walk-in-the-park but going below 1mg starts becoming challenging and I would never wish anyone go “cold-turkey” from any dose of Suboxone heaven forbid 8mg daily.  I an not a doctor and you need to get all dosing information from your doctor. This information is being provided as an opinion and possibly something you can suggest to your doctor and ask your doctor if it is something they are willing to allow you to do.

My Personal Taper From Suboxone

First three days 24mg Suboxone, then three days at 16mg, then two days at 12mg to finish out the first week.  After getting past the first week you have bypassed the hardest days of opiate withdrawal.  From then on a moderate taper down to 4mg Suboxone daily.  I then took another TWO full months to taper from 4mg to zero taking the last month to go from 1mg to zero by cutting Suboxone strips into very thin tiny (almost as small as a pin head) that when you put under your tongue you barely taste the “orange” stuff.

Getting to 1mg isn’t really so tough and if you take it slow enough you will be able to quit.  This was my personal experience and should not be used by anyone without approval and guidance from your doctor!!

Notice this first month chart, how it loads heavy at first to curb the hard part of opiate withdrawal and ramps down fast to a lower dose.  You would be surprised how STRONG 4mg of Suboxone is once you break the Oxys.  In fact 2mg Suboxone can kill some pretty bad withdrawal if you give it a few hours time (patience!!!) and let yourself experience a little discomfort.

Good luck!!

Planning a Drug Taper

The Tool for creating this graph was made by a programmer (me) and only does a month at a time for now but I will update it to do more as soon as I get time. :)

 

View larger image HERE or open the Suboxone Taper Charting Tool HERE

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What are the differences between Buprenex, Butrans, Buprenorphine, Suboxone, and Subutex?

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What are the differences between Buprenex, Butrans, Buprenorphine, Suboxone, and Subutex?

All of these medications are similar in that they contain a shared active ingredient buprenorphine hydrochloride.  They are all different medications with the exception of buprenorphine which is the active ingredient in all medications.  There are subtle differences between each of the medications Buprenex, Buprenorphine, Suboxone & Subutex.   The main differences are in the dosing, usage and marketing of the medications.  Some contain additional active ingredients that make the drug combination useful for different purposes.

The table below is a basic summary of the differences between Buprenex, Butrans, Buprenorphine, Suboxone, and Subutex.

 

Brand Name Generic Name Active Ingredients Delivery Method Marketing Towards Distributer Strength
Buprenex® Buprenorphine Buprenorphine HCI Intravenous, Intramuscular Typically cats & dogs for pain Reckitt Benckiser Pharmaceuticals Inc .3mg in 1ml
Suboxone® Buprenorphine, Naloxone Buprenorphine HCI & Naloxone HCI Sublingual Tablets Humans for Opiate Dependence Reckitt Benckiser Pharmaceuticals, Inc. 8mg with 2mg / 2mg with .5mg
Subutex® Buprenorphine BUPRENORPHINE HCI & NALOXONE HCI Sublingual Tablets Humans for Opiate Withdrawal Reckitt Benckiser Pharmaceuticals, Inc. 8mg / 2mg
Suboxone Film® Buprenorphine, Naloxone Buprenorphine HCI & Naloxone HCI Sublingual Film Humans for Opiate Dependence Bryant Ranch Prepack 8mg with 2mg / 2mg with .5mg
Butrans® Buprenorphine Buprenorphine HCI Transdermal System (through the skin via a patch) Humans for Moderate to Severe Chronic Pain Purdue Pharma 5 mcg/hour, 10 mcg/hour, and 20 mcg/hour.

 

Notice

 This information was compiled using many sources and should be used for entertainment purposes only.  

Buprenex

Buprenex is typically marketed for animals such as cats and dogs. Buprenex contains the same active ingredient as all buprenorphine medications.  Buprenex does not contain Naloxalone like other versions of the drug because it is not intended to be used for withdrawal of opiates.

 

Buprenex Injection

Buprenex Injection

Proprietary / Brand Name: Buprenex

Generic Name: buprenorphine (byoo-pre-NOR-feen)

See Buprenex details 

Active ingredients: buprenorphine HCI (buprenorphine)

 

 

 

 

Butrans

A strong prescription pain medicine that contains an opioid (narcotic) that is used to treat moderate to severe around-the-clock pain.

Butrans5mcgButrans10mcgButrans20mcgButrans is a partial opioid agonist product indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time.  Each Transdermal patch is designed to deliver medication over a 7 day period.

BUTRANS is a rectangular or square, beige-colored system consisting of a protective liner and functional layers. BUTRANS is available in three strengths:

  • BUTRANS 5 mcg/hour Transdermal System (dimensions: 45 mm by 45 mm)
  • BUTRANS 10 mcg/hour Transdermal System (dimensions: 45 mm by 68 mm)
  • BUTRANS 20 mcg/hour Transdermal System (dimensions: 72 mm by 72 mm)

Pharmacokinetic information on Butrans in Healthy Subjects, Mean (%CV)

Single 7-day Application AUCinf
(pg.h/mL)
Cmax
(pg/mL)
BUTRANS 5 mcg/hour 12087 (37) 176 (67)
BUTRANS 10 mcg/hour 27035 (29) 191 (34)
BUTRANS 20 mcg/hour 54294 (36) 471 (49)
Multiple 7-day Applications AUCtau,ss
(pg.h/mL)
Cmax,ss
(pg/mL)
BUTRANS 10 mcg/hour, steady-state 27543 (33) 224 (35)

Suboxone

Suboxone is indicated for the treatment of opioid dependence.  Suboxone contains Buprenorphine HCI and Naloxone HCI.  Administer Suboxone sublingual film or tablets sublingually as a single daily dose.  Suboxone film and tablets come in two sublingual dose sizes: 2 mg buprenorphine with 0.5 mg naloxone and 8 mg buprenorphine with 2 mg naloxone.

Suboxone Tablets

Tablets vs Film

Patients being switched between SUBOXONE (buprenorphine and naloxone) sublingual tablets and SUBOXONE sublingual film should be started on the same dosage as the previously administered product. However, dosage adjustments may be necessary when switching between products. Because of the potentially greater relative bioavailability of SUBOXONE sublingual film compared to SUBOXONE (buprenorphine and naloxone) sublingual tablets, patients switching from SUBOXONE (buprenorphine and naloxone) sublingual tablets to SUBOXONE sublingual film should be monitored for over-medication. Those switching from SUBOXONE sublingual film to SUBOXONE (buprenorphine and naloxone) sublingual tablets should be monitored for withdrawal or other indications of under-dosing. In clinical studies, pharmacokinetics of SUBOXONE sublingual film was similar to the respective dosage strengths of SUBOXONE (buprenorphine and naloxone) sublingual tablets, although not all doses and dose combinations met bioequivalence criteria.

 

Subutex

Subutex is indicated for the treatment of opioid dependence.  Subutex contains buprenorphine HCI and does not contain Naloxone like its’ brother Suboxone.

The pharmocokinetic properties of Suboxone and Subutex are very similar

 

Pharmacokinetic parameters of buprenorphine after the administration of 4 mg, 8mg, and 16 mg Suboxone® doses and 16mg Subutex® dose (mean (%CV)).
Pharmacokinetic Parameter Suboxone®
4 mg
Suboxone®
8 mg
Suboxone®
16 mg
Subutex®
16 mg
Cmax, ng/mL 1.84(39) 3.0(51) 5.95(38) 5.47(23)
AUC0-48,
hour. ng/mL
12.52(35) 20.22 (43) 34.89 (33) 32.63 (25)

 

 Summary

While each of these medications are similar, there are significant differences in the delivery, dosage, delivery and purpose.  This information was compiled using many sources and should be used for entertainment purposes only.

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Morphine Addiction Treatment – Buprenorphine Naloxone (Suboxone or Subutex) vs Methadone

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Quitting Opiates – Which works better Suboxone or Methadone

There is no silver-bullet answer to this question, but in my experience buprenorphine naloxone (aka Suboxone) is a better choice because I think it works better and it is easier to quit once you reach that point.  Quitting Suboxone or Methadone can be a challenge, but I think Suboxone is just a little easier.

There are some variables involved that will probably be considered, price of course is always on the list unless you are made of money.  Then you have to ask the question, does the drug do what is promised, will it help you quit abusing opiates and get you off opiates ultimately with the least amount of pain possible.  The third factor I would consider is how easy is it to quit taking the medication once you are ready, because you are trading one opiate for another with either choice.

Summary – There are basically two choices of approved drugs for opiate addiction

  • Buprenorphine Naloxone (aka Suboxone, Subutex)
  • Methadone

 

Summary – How to decide between Suboxone or Methadone

 

  1. Cost of Suboxone or Methadone Treatment Plans
  2. Effectiveness of the drug in getting you off of opiates and keeping you off them.
  3. Ability to quit the drug without major problems or withdrawal symptoms.

Suboxone Strips

Suboxone (aka Buprenorphine Naloxone) Treatment Plan Typical Prices

First Month Costs

Initial Doctor Visit or Evaluation Visit – Around $300

Regular Visits for counseling and script refills average around fifty bucks weekly –  $200 first month

Cost of Suboxone medication per month, assuming one and a half 8mg Suboxones’ daily (45 pills * $10) – $450 first month.  You will probably start at two or three 8mg Suboxones the first few days and rapidly drop to one 8mg daily and possibly 1/2 of an 8mg Suboxone by the end of the month.  4mg of Suboxone is still a very potent dose.

Second Month Costs

Regular Visits for counseling and script refills average around fifty bucks weekly –  $100 second month.  Many doctors will allow you to visit less frequently after you build some trust in the relationship.

Cost of Suboxone medication per month, assuming 1/2 of an 8mg Suboxone daily (15 pills * $10) – $150 second month

Third Month Costs

Regular Visits for counseling and script refills average around fifty bucks weekly –  $100 third month.  Many doctors will allow you to visit less frequently after you build some trust in the relationship.

Cost of Suboxone medication per month, assuming average of 1/8th of an 8mg Suboxone daily, plus a few extra pills to cut as small as possible for tapering (use two pills for an entire month period!  (10 pills * $10) - $100 third month

Total Cost of Suboxone Treatment over a three to four month period:  $1,400.  This sounds like a crazy high number, and it is expensive if you don’t have insurance coverage, but it is a low price to pay compared to the alternative.  I don’t know about you but I know of many people who were at a two hundred dollar per day habit so the Suboxone was actually cheaper than the daily routine.

 

Effectiveness of Suboxone

Buprenorphine is a relatively new drug for treating opiate addiction, such as oxycodone addiction or even heroin addiction.  Suboxone has become very popular in the US, quite simply because it works for most people, and the numbers are slightly better than Methadone for number of addicts who remain clean after a period of months after treatment.

From personal experiences I can say that it works because I’ve seen friends go through the treatment with good success.

 

Ability to Taper off of Suboxone after the treatment

This is probably one of the weak points for Suboxone, but it is no cakewalk for Methadone either.  You are trading one opiate for another, so you are technically not “clean” until you kick the Suboxone habit, and that is not as easy as it might seem.  But don’t let that deter you from improving your life, or possibly saving it!

 

Methdone Costs, Effectiveness and Ability to Taper off

I have not seen person experiences or talked to people who have, so do not have this information in as much detail.  The costs are similar to Suboxone for treatment however the Methadone drug itself is very low cost.  Methadone has a longer half life so technically you would think it will be easier to wean off of, but I have heard of many addicts that are on methadone for life.

I am definitely biased towards the Suboxone but I recommend you try to find more detailed info on Methadone first.

If you are looking for a medication for Heroin addiction treatment, Morphine Addiction Treatment, or Hydrocodone Addiction Treatment, then learn about buprenorphine naloxone and methadone  as much as possible before making a decision.

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Illustration Showing How Buprenorphine Blocks Opiate Receptors

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Great Illustration Showing How Buprenorphine Blocks Opiate Receptors

This illustration is owned by naabt.org so I am posting a link to the page.

 

This makes things crystal clear on how Suboxone works.  The Buprenorphine kind of fills in the receptor with junk so that the opiate doesn’t fit in perfectly.  Kind of like if you put a bunch of boxes in your  four passenger car, and you can only get two passengers in at a time.  The Bupe limits the opiate effect.   Cool!

How Buprenorphine Works

How Buprenorphine Works

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Chronic Pain Management Using Buprenorphine

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How Buprenorphine Works for Pa in Management or Opiate Addiction

Buprenorphine is being used for drug addiction treatment because it is a long-acting opioid (24-72 hours) and it produces less respiratory depression at high doses than other narcotic treatment drugs. Buprenorphine is much more potent than morphine as an analgesic; and like morphine, it produces dose-related euphoria, respiratory depression, and sedation.

How Buprenorphine Works

How Buprenorphine Works

Low doses of buprenorphine can eliminate opiate withdrawal symptoms

When treating someone who is addicted to opioids, a low dose of buprenorphine is strong enough to allow an addict to stop taking opiates without  experiencing withdrawal symptoms. Side Effects of buprenorphine are minimal.  The most common was sedation but it was mild.

Other side effects reported in less than 5% of the patients in this study were as follows:

  • Sweating
  • Hypotension
  • Hypoventilation
  • Vomiting
  • Headache
  • Nausea

Acute pain treatment can be hindered by the use of buprenorphine.  Suboxone has phannacological properties, and emergency care centers  find it difficult to control acute pain by using full agonist opioids because their effects will be minimized by the buprenorphine molecule.  Opioid tolerance also contributes to diminished pain relief as a result of the chronic use of a long lasting opioid, Special consideration needs to be given to potential circumstances that buprenorphine maintenance

 

Vivitrol (naltrexone) and Suboxone (buprenorphine and naloxone) are the new hope for opiate addicts

Vivitrol (Naltrexone) is a monthly injection given in a physicians office. It controls addiction by preventing euphoria from other opioids or alcohol.

Suboxone (buprenorphine and naloxone) works by limiting the euphoric effects of opioids but at the same time preventing withdrawal symptoms. While there is no perfect treatment, both of these medications can be safe and effective when used properly.

These are far lower cost to an addict than typical opioids.  I know of some addicts who were spending $160 daily to support their addiction, and spend a good portion of the day seeking out the drug for fear of intense withdrawal.

A doctor mentioned some real-world experiences with subxone…

To see a 42 year old nurse to break into tears when talking about how she feels like she got her life back due to these Suboxone treatment.  To have a young mother hug me while crying because she was so happy to be able to care for her children and be normal again.

Potentially fatal interactions with other depressants such as benzodiazepines (Valium, Xanax, Ativan), THC, alcohol, sleep aids, muscle relaxers, etc.

Withdrawal: Although the addict feels like dying, withdrawal from opiates in itself is not lethal (as withdrawal from alcohol and benzodiazepines can be)

 

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Legal Uses of Buprenorphine for pain (Buprenex®) and opioid addiction

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Legal Uses of Buprenorphine (Buprenex®) & (Suboxone® and Subutex®).

(based on DEA Narcotic Addict Treatment Act effective 2006)

  • Treatment of pain under the trade name of (Buprenex®)
  • Treatment of opioid addiction under the trade names (Suboxone® and Subutex®).

 

Prescriptions Dispensed for Buprenorphine in the US

In 2009, there were 5,080,000 prescriptions for buprenorphine dispensed.

In 2010 (up to September) there were 4,600,000 buprenorphine prescriptions dispensed which is on a pace to reach 5,750,000 prescriptions dispensed by the end of 2010.

 

69 Tons of Pure Oxycodone & 42 Tons of pure hydrocodone were dispensed the US in 2010

Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in United States

How many pills that equates to for every single person in the Unites States for a year?  

  • 40 Percocets
  • 24 Vicodins

Parts of New Mexico have seen tenfold increases in oxycodone sales per capita and fivefold increases in hydrocodone. The state had the highest rate of opioid painkiller overdoses in 2008, with 27 per 100,000 population.  The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.

2001 Narcotic Addict Treatment Act Amendment

Amended to allow qualified physicians, under certification of the DHHS, to prescribe schedule III-V narcotic drugs (FDA approved for the indication of narcotic treatment) for narcotic addiction, up to 30 patients per physician at any time, outside the context of clinic-based narcotic treatment programs.

2005  Narcotic Addict Treatment Act Amendment

The patient limit was increased to 100 patients per physician, for physicians who meet the specified criteria, under the Office of National Drug Control Policy Re-authorization Act.

2006   National Drug Control Policy Re-authorization Act

The patient limit was increased to 100 patients per physician, for physicians who meet the specified criteria, under the Office of National Drug Control Policy Re-authorization Act.

 

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Suboxone® and Subutex® are the only treatment drugs that meet the requirement of this exemption. Currently, there are nearly 15,700 physicians who have been approved by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the DEA for office-based narcotic buprenorphine treatment.

Of those physicians, approximately 13,150 were approved to treat up to 30 patients per provider and about 2,500 were approved to treat up to 100 patients.

More than 3,000 physicians have submitted their intention to treat up to 100 patients per provider. IMS Health National Prescription Audit Plus data indicate that 5.08 million buprenorphine prescriptions were dispensed in the US in 2009.

 

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