Since I don’t have much on my mind tonight, I’ll respond to a cleaned up comment from a reader:

I have been on opiates for about 15 years now. I’m 43 and I have been through hell and back again. I’m doing the Suboxone thing now.  It’s a little better than the methadone clinic; that place just wanted your money and they still treated you like a junkie with no hope ….hope…… I’m starting to wonder if there is a way out with Suboxone.

J.T. Junig, MD, PhDJ.T. Junig, MD, PhD is a Psychiatrist and PhD Neuroscientist in solo, private practice in NE Wisconsin. I treat adults, children and adolescents for all psychiatric conditions, with an emphasis on improving the strength of the doctor/patient relationship through longer appointments, greater access, and frequent e-mail communication. I teach psychiatry at the Medical College of Wisconsin, and provide psychiatric servicies for the U of WI Oshkosh Campus. Finally, I provided expert witness testimony for a wide range of cases related to psychiatry, neurology, addiction, and chronic pain. I am Board Certified by the American Board of Psychiatry and Neurology, and lifetime-Board Certified by the American Board of Anesthesiology.

Editor:  Saad Shaheed

You have the same withdrawal problems trying to wean from it just like anything else.  Your body has to adjust to being sober and being on Suboxone is not being sober.  I hope someday the people at the clinics quit turning their heads and look at opioid users as real people needing real help. I would love to just stop taking the Suboxone. I am done (with taking it) but I have children and a wife to take care of and a demanding job that I have to keep so when am i suppose to find the time to go through the withdrawals?

It’s a messed up way of life with the appointments, with drug counseling during the middle of the day, and getting the script from the doctor, taking a pee test every time you go… oh well, this is what you have to do if you want a halfway normal life as an addict.  It becomes a part of your life.  It will be over someday, just not today.

Wow—so much for the joy of recovery!  To the writer, I feel for you—you are clearly miserable.  I will try to throw out a few suggestions, and I hope they are useful.  I realize, of course, that some people are simply not as ‘happy’ as others;  I’m probably more on the unhappy side myself, and there is only so much ‘cheering up’ that can be done for me—and I imagine the same is the case for you.

I realize that life is tough. Most of us spend most of our lives working, and we all have days when it feels like we aren’t getting anywhere.  But you HAVE gotten somewhere.  After years of being yanked around by your addiction, you are in a position to find some peace of mind.  That alone is cause for gratitude. And when it comes to hope vs. gratitude, I recommend gratitude.

Hope rests on the acknowledgment that your current situation is bad, and allows every morning to be cause for one more disappointment. But gratitude assumes the opposite—that you are blessed by good fortune–and cannot be taken from you by anyone else. As Benjamin Franklin wrote, he that lives upon hope will die fasting.

I disagree with your comment that ‘being on Suboxone is not being sober.’  Sez who?!  I see addiction as an obsession—a state of mind that crowds out other interests, that when activated, limits our insight and changes our perceptions in order to serve the addict’s will.  The unique action of the partial-agonist buprenorphine eliminates that obsession.  Are you ‘totally clean’ on buprenorphine?  I don’t know—but you are clean enough.  To argue the point any further is looking a gift horse in the mouth, and a waste of time for both of us.

Now that you are clean, you have to live life on life’s terms.  When you were actively using, your problems were easy to ignore.  You fooled yourself into placing all of your ‘hope’ on whether you had something to keep the sickness at bay, and that was all you had to worry about.  Now that you don’t have the worry and drama chasing you around, you are feeling things.  You look in the mirror and feel shame.  You look at the bills and feel fear.  You don’t like feeling those things… so you wish things would change.  A part of you is even thinking that Suboxone is the problem—that maybe you’d be better without it.

I hear you, about the appointments and other requirements of being prescribed a medication—any medication.  It is never convenient to need medical care.  But again, things could be worse—much worse.  You could be sitting in prison, or your kids could be sitting next to your grave.  Be grateful.  And as for the ‘pee tests’, I encourage you to see them differently.  For years you taught everyone that you couldn’t be trusted.  The tests are your chance to regain at least some of that trust.  Those tests allow you to stop explaining yourself.

This is a very dangerous time for you.  You are miserable, feeling trapped, and fantasizing about stopping the medication that is helping you stay clean.  Step back and see what is going on.  Were you my patient, I would discourage any talk about ‘stopping Suboxone’ until you found gratitude, or were at least trying to find it!

I just realized that the decision to discharge a person from residential treatment is similar to the decision of when to stop buprenorphine.  In both cases, you don’t start thinking about changing things until the person is grateful for where he is.  For the writer, you have more work to do before you need to worry about withdrawal from buprenorphine.  For now, take a look at your wife, your children, and your demanding job… and be grateful.  Stay clean, follow the plan, and be grateful.  Everything else will take care of itself.

Courtesy: PsychCentral

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