Suboxone: Trading One Prison Cell for Another

Suboxone seemed like a get-out-of-jail-free card, the answer to my opiate addiction. Instead, I had a new ten-year addiction, complete with thinning hair and lost motivation.

suboxone-addictionThe day I realized I was a junkie began like any other. I woke up late on a Tuesday in 2001, rushing to get to a work meeting on time. Just the normal routine. The only difference was on this day I did not take the white tablet that had become my secret and constant companion for the previous year. I had forgotten to. In the middle of my meeting I began to feel sick. Really sick: sweating, stomach churning, disoriented, twitchy and anxious. I thought I was coming down with the stomach flu. By force of habit, I reached in my purse and took a pill from my hidden stash of Vicodin. In a matter of 30 minutes my flu symptoms were gone. The distress over getting sick was replaced by an overwhelming sense of dread. I knew what I had become.

I was in a death-dance with medication obtained from online doctors and pharmacies. Not a single soul who knew me was privy to this information. Looking back, I think people around me must have known something was up. There were mood swings, erratic behavior and outbursts. I was immersed in a high stress business, in a dysfunctional environment. The drama level was soap opera high, and getting higher by the day. Maybe I just seemed frazzled by the roller coaster my colleagues and I found ourselves on. Nobody confronted me when I would take pills in their presence (from a bottle of Tylenol no less). I would often refer to having bad headaches, which was true. The meds in that bottle however were not Tylenol. Hindsight being 20/20, I often wish I had admitted my problem then, and gotten myself into treatment. I could have saved myself 13 years of misery, secrets and shame. I guess I wasn’t ready. We do what we do until it is more painful to continue than it is to face change.

I was cloaked in denial. My wardrobe and obsession with appearances made it easy to blend in with the rest of humanity. Driving down the freeway on one of my increasingly frequent Mexican holidays, hair tossed by the breeze of a convertible, I looked like one more day-tripper. Inside, I was desperate to exorcise the hungry ghost who was surely running my life.

Fast-forward one year. In 2002 I was no longer working for the same dysfunctional company. I moved on to another even more dysfunctional firm that was headed (along with me) for disaster. My new job required moving to New York City. I was excited about the prospect of change and had fantasies of creating a new life there. In recovery this is well known as a “Geographic,” but at the time it seemed like just the thing I needed.

The Internet was a tool I used to obtain prescription meds to avoid legal hassles. My scripts were legitimate, even if my claims of back pain were not. It makes sense that when I decided to get off painkillers I’d go back to the well. I searched my new city and found a number of clinics. Unfortunately they all relied on methadone to get patients off of opiates. I was adamant that I would never take methadone, and I put myself through three wicked weekend detoxes. These all ended the same, with me going back to the drug I simultaneously needed and hated. The drugs had stopped working. I was at the sorry place where taking pills was required for me to get out of bed in the morning. Unfortunately I had done damage to the lining of my stomach from the high level of acetaminophen in the drug I preferred. I was unable to keep enough of the meds in my stomach to get high; I could keep just enough down to stave off that awful brand of sickness every junkie comes to know well.

One Sunday in August 2003 I was out shopping with a friend. I had taken my usual ration of pills, but today nothing was working to keep me well. As we were walking down a steamy sidewalk I felt like I was going to throw up and pass out, not sure which would come first. I told my friend I felt faint and had to sit down. Once steadied, I excused myself for the rest of the day. I got home and knew my time was up. I went online and found a doctor who advertised outpatient opiate detoxification services. The ad claimed it would be pain-free and confidential.

A few days later I met Dr. N. He was an eccentric guy, which I would come to find was de rigueur for addiction doctors. He charged $1,000.00 cash in advance for his services, which I happily paid. I was given a prescription for Subutex, and about four other medications to assist with opiate withdrawal, covering symptoms from leg cramps to nausea, anxiety, and insomnia. I only found myself in need of and interested in one of those. Subutex is the brand name for buprenorphine which had recently been cleared for use in the US for detox and maintenance. Dr. N had arrangements with a few different pharmacies that carried the medicine for his “special patients.” I was desperate, really sick and as scared as hell.

I took the first orange tablet, and within 30 minutes I felt better. In fact I felt more than better, I felt absolutely great, which in retrospect was not a good sign. I had a slight twinge of guilt, because I was most assuredly high as a kite. So this was the cure? I signed up then and there with no plan to ever stop taking my new secret pill.

Here are some things I did not find out in my exhaustive search for a panacea. According to addiction specialist and former addict Dr. Steven Scanlan, “Suboxone (buprenorphine plus naloxone) is a powerful opiate-an anesthetic to emotional pain. It immediately alleviates anxiety and depression and makes a person feel more emotionally stable. A lesser dose of Suboxone (2 mgs a day) will block an estimated 80 percent of a person’s feelings, while higher doses can make a patient practically numb.” He goes on to say that the studies that are done on the drug and its effectiveness as a recovery tool only report on patients for about a month post detox. The studies are paid for, run, and reported on by guess who? The pharmaceutical company that holds the patent on Suboxone. Currently there are no long-term case studies of patients on buprenorphine maintenance.

I learned the hard way about the side effects of opiate replacement maintenance. In the first year I felt and behaved a lot better than when I was choking down 10 or 12 Vicodin a day. The first indicator that there might be something else going on was the onset of dental issues which required my having four teeth pulled. The other issues were harder for me to connect to my buprenorphine use. I found it hard to wake up in the mornings, and even harder to get any place on time. The weirdest part was that I didn’t care. My personality had morphed into someone different than the me I used to know. Over the course of four years I lost my career ambitions. The only thing I did with consistency was keeping my appointments with Dr. N. I continued working, but too often found myself suddenly and inexplicably sacked. It bothered me, but I never had the presence of mind to see that my behavior had gone from company “superstar” to being the first and easiest person to get rid of. I fell into survival mentality. I took lower and lower level jobs, keeping a roof over my head, but letting everything, particularly my sense of self-worth, slide. I also noticed that my hair was thinning in the front, like a man with a receding hairline. This concerned me greatly and I began seeking various potions that promised to restore my formerly glorious mane.  Article Link “the fix”…

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