“I will never be clean. I will never have a day that I don’t struggle. Treatment doesn’t work. Nothing works.”
—My patient prior to treatment. (Now clean and sober for several months since)
First things first.
How many people have died? How many slaves to opiates? How many with broken homes and hell on earth? Too many, that’s for damn sure.
Luckily, there are now medications that can really make a difference in someone’s life. Medications that help with withdrawal, cravings, and relapse.
Suboxone/Subutex is not the cure-all. But it’s not snake oil either.
In case after case, I have seen people turn their lives around. And if you are reading this, then maybe you are next. Maybe today is the day. The new day. Your first day of a new life.
Now, let’s talk a little about some things you should know about a medication that could save your life: Buprenorphine. From here on out, I will refer to it by it’s commonly used names Suboxone or Subutex.
9 Things You Should Know Before Taking Suboxone
1) You need to be in withdrawal
Withdrawal sucks. It is painful and often the largest hurdle for those trying to escape their addiction.
You need to be in withdrawal from opiates before starting suboxone/subutex. Somewhere between 24 and 72hrs without any opiates will likely be enough.
Why is this necessary? Because subutex will preferentially bind to the same receptors opiates bind to. If you aren’t in withdrawal, it will push you into withdrawal and you will feel worse.
Many people have headaches and nausea when starting suboxone/subutex and it is often because they are not in deep enough withdrawal when starting.
2) Taste, Constipation, and Headaches
No medicine is without side effects.
These are probably the most common side effects/complaints that I have heard. But there are others, so talk to your doctor and educate yourself.
It tastes horrible
There are different methods for taking buprenorphine: Patch (for pain), injected under the skin (for those already stable on sublingual form), absorbed via the buccal mucosa, or absorbed sublingually (under the tongue).
Most people that take Suboxone will take the form that dissolves under the tongue. And I am told, it tastes horrible. So be warned.
Here’s the other thing: After taking your Subutex, it’s probably best to wait 15-30 minutes before eating/drinking anything.
If you are taking opiates, then you probably already deal with constipation. You may want to try increasing the fiber in your diet and/or some over the counter stool softeners. Try to stay away from laxatives or enemas unless symptoms are severe. Always tell your doctor if you are having problems. Your case may be different.
The headaches could be a side effect of medication or a consequence of not being fully in withdrawal when starting treatment. If withdrawal is the case, then the headaches should get better after a few days.
Remember: Always tell your doctor if you have side effects.
3) There’s no easy way
You already know this. But there’s no easy way. No perfect way.
Suboxone/subutex can lead to dependence issues just like opiates. And if you stop Suboxone cold turkey, you will have withdrawal.
4) Opiate dependence vs Chronic pain
You should know the difference. And have an idea where you fall. One or the other or both. Suboxone/subutex are indicated for opiate dependence and not chronic pain. (But buprenorphine has been approved for the treatment of chronic pain in other forms of medication.) So take that information for what it’s worth.
5) Benzos (xanax, klonopin, valium, ativan, etc)
Taking suboxone/subutex with benzodiazepines or other CNS depressants should be avoided if at all possible. There is increased risk of sedation, respiratory depression, coma, and death.
But here’s the thing. If you are taking 200mg of oxycodone a day along with benzodiazepines, then you are at increased risk for this already.
So you have to weigh the pros and cons. If you aren’t abusing benzodiazepines, then there may be a safe way to dose your medications. You just need to talk to your doctor. Hiding benzodiazepine use is not helpful or very smart. Be honest and hopefully your doctor and you can come up with a solution.
Most doctors feel the benefits of Suboxone treatment outweigh the risks of not treating just because someone is still taking benzos.
6) Take your medication as prescribed
Self medicating is at the heart of addiction.
Maybe there was a time you were just trying to fix the pain. Or maybe you just needed enough energy to get through another grueling shift at work. Or maybe you were trying to forget about your problems for a few hours.
Whatever got you here, it’s now time to make some changes.
Understand your body and be proactive in your health.
Find a doctor that you can talk to and work with.
Think long term and look at the big picture and do not take more of your medications than prescribed.
Here’s what seems to happen. People get anxious or fatigued. So they take an extra strip/tab here or there. And then they start to run low. So by the week before their appointment, they have to decrease their dose to get by.
This constant flux is not good. You need to find a stable dose and learn to deal with the fatigue and anxiety.
Addiction isn’t just about bad choices but at the same time, you have to start making better choices.
So take your meds as prescribed and talk to your doctor if you think something isn’t working.
7) Everybody is different
There is no ONE RIGHT WAY.
In other words, what works for you may not work for someone else. You may require a different dose. You may not need to stay on treatment for long or maybe you will need maintenance therapy for years or even for your lifetime.
There are going to be people that criticize you. This is a fact. If you take medications to help you, there will be some people that think you are taking the easy way out or that you are not really clean. This is a load of crap. You have to do what is best for you.
Your path is yours and yours alone. Walk it wisely. And don’t worry about what everyone else is doing.
8) Point your life in the direction you want to go
Suboxone/subutex is not the answer to all of life’s problems.
I have written a lot about this. No need to beat a dead horse. Getting clean is just a part of the life you are building. You need to make it meaningful. You need a life worth living.
You do this by starting with something small. Something you can control. Something you can do that will make a small difference. I have written about cleaning out a closet. Psychologist Dr Jordan Peterson recommends cleaning your room. The idea is take a small area of your life and make it just the way to you want it. When you do this, it starts to spill over to other parts of your life.
You don’t have to be perfect.
Just do something.
Addiction is a demon with many heads.
There will be times you feel it has the best of you. Don’t give up! It’s the fight that makes the difference.
Some people define success in a way that is unreachable. In other words, they design a life in which they will always feel like a failure.
What is success to you? Is it being off drugs? Is it being off Suboxone or other medications? Or is it having healthy relationships, a stable job, and a purpose in life?
Think past the drugs and define success with what you really want and in a tangible way.
Don’t just focus on goals. Think about your values. What you hold to be true. And what you want your life to be about.
Hope is a weapon.
And in this war…..you need all the weapons you can carry.
If you need help or just want more information: 662-322-0996
You can read more Here: DOCTORCHRISPARK.COM
This article was meant for general information. It is not intended as medical advice. Don’t get medical advice from the internet. Go see a doctor.
Hey Dr Park I been reading your posts and I think they are great. You make so much sense of what life should be I am so glad I have you as my Doctor. I see so much addiction in my world around me from people stealing from me to learning to lock my meds up when certain people come to visit me. Thanks Dr Park
Make a more new posts please 🙂