Answer Addiction

Tag: Suboxone

  • The Never-Ending Drug Hustle Behind Bars

    The Never-Ending Drug Hustle Behind Bars

    “While I went to high school with casual weed smokers and worked at various jobs with weekend coke snorters, I was entirely unprepared for what I’ve seen in state prison.”

    This article was originally published by The Marshall Project, a nonprofit news organization covering the U.S. criminal justice system. Sign up for their newsletter, or follow The Marshall Project on Facebook or Twitter.

    I was on the phone with my wife as usual on a Saturday evening a few months ago when my prison’s P.A. system crackled and a stressed-out voice announced: “All rec yards are closed; offenders will report back to their dorms immediately.”

    Something big was clearly afoot, and everyone rushed to the front windows to get a better view. People spoke in hushed voices, not the usual clowning, speculating about what might have happened.

    It turns out that eight people had overdosed at once, most likely on “spice.” They passed out on the recreation yard, laid out side-by-side on the concrete while nurses and guards ran around with stretchers and wheelchairs trying to keep control and render medical assistance, in that order.

    As far as I know, one of them is now dead, while seven have since recovered and were transferred to other compounds. I think the one who died only had about 30 days left on his sentence.

    You can bet on two things following from that sort of trainwreck. One, the addicts in here will continue snorting and smoking anything they can find. And two, the rest of us will pay for the mess they’re making.

    I guess I was a little naive when I was first locked up, thinking it must be hard to obtain drugs and get high while incarcerated. But to my shock, it was as common or more so than on the outside. (I’m probably in the minority in here because I don’t use, it’s that pervasive.) Spice, weed, Suboxone, Neurontin, Seroquel, orange peels—people try to get high on whatever they can find, everywhere I’ve been locked up, and no matter what security measures are in place to prevent it.

    When I was first in the jail in Washington, D.C., inmates openly smoked “K2” while gathered in cell doorways. You smelled that synthetic stuff more often than weed or cigarettes, though those were common too. Some bothered to try and conceal it by blowing the smoke down the toilet, but most didn’t.

    I would see correctional officers walk by and pretend not to notice; they aren’t paid enough to care. People knew which C.O.’s would write them up, and that was an awfully short list.

    And while I went to high school with casual weed smokers and worked at various jobs with weekend coke snorters, I was entirely unprepared for what I’ve seen in state prison. These are mostly desperate addicts with little else to organize their days around besides the next fix. Getting high is their whole bid. The money they hustle up or that their family sends them, every hard-earned dime of it, is spent on drugs. All they get is small amounts of low-quality stuff, but they’ll take it. Because even at the ridiculously high prices this stuff sells for behind bars, that crummy, overpriced little piece will keep the shakes away for another day.

    To give you some idea, a 16th of a strip of Suboxone (a “piece” in our parlance) can sell for $15 here, when supply is scarce. Go Google what a Suboxone strip looks like, imagine that cut in fourths, and then fourths again. It’s miniscule. And then remember that those $15 could have bought that addict 50 ramen soups from the commissary.

    Even at the normal price of $5 for a piece, it’s a terrible waste. Five dollars is a lot of money in lockup.

    They hustle to get it—they steal from the kitchen and sell the food, they gamble on sports or cards, they iron shirts or wash dishes, whatever it takes. Sometimes they even use sex as currency for the price of a high, or are coerced into it to cover their drug debt.

    Or their families, or girlfriends, or buddies back home, are sending money, thinking it’s going toward keeping them well-fed and well-clothed. It’s likely money that was hard to come by, because most people in here are decidedly not wealthy. Rich drug abusers go to treatment, not prison.

    Plenty of inmates have prison jobs, but those pay on average about a couple bucks a day—and you can’t get high too often on just that.

    Most drugs only come in here in one of three ways: mail, visits, and corrupt C.O.’s.

    Prison officials can take steps to block the first two kinds of smuggling, of course. Blocking the mail route is easy: Prisons are moving to give inmates photocopies of letters instead of the originals. And at visitation, they can strip-search us and make us wear embarrassing jumpsuits that zip up the back (the officers have to do that part). They also harass our visitors about what they’re wearing and their feminine hygiene products, to make sure that nothing gets in.

    And then when people overdose, they lock us all down, and shake down our lockers, and take away our recreation time. They do random drug tests, and run drug-sniffing dogs through the dorms now and then.

    But it doesn’t change anything. Until they pay correctional officers a decent wage, or strip-search them every day, there’ll always be a few guards who will take the risk of bringing in small quantities of drugs to sell, given the enormous paydays at stake. Again: Have you ever seen a Suboxone strip? It’s so small and nondescript, it’s like it was made to be smuggled.

    The news media has reported statistics that highlight the scale of the problem: Virginia has just under 30,000 inmates spread across more than 40 facilities; they received almost two million pieces of mail in 2018 and 225,000 visits. That year, there were 562 seizures of drugs inside those penitentiaries; 57 emergency-transport runs to hospitals carrying overdose patients; six interceptions of substances coming in through the mail; four prison employees prosecuted and 13 who resigned or were fired for smuggling. The numbers say that the state is barely scratching the surface of the problem.

    Meanwhile, treatment programs just don’t work in here. Prison is dismal and there isn’t much that’s positive to focus on, to keep an addict’s mind more productively occupied. The incarcerated person who is secure and self-aware enough to admit he has a problem and needs help is a rare breed.

    “It’s wide open over there,” you’ll hear addicts say with glee in their voice, when they’re called to pack their belongings because they’re being shipped off to the two-year residential treatment facility that Virginia runs.

    The big picture—that we incarcerate people for their addictions and then don’t give them adequate treatment—is a silent national disgrace. But it’s the little picture that I have to live with every day, that angers me and breaks my heart. It’s the individual human beings who have been failed by the system, and the often-already-poor families who are devastated even further by loved ones caught up in the cruelties of a vast enterprise.

    One of my last bunkies was pitiful: a lying, scheming, thieving addict who ended up having two fistfights within hours over his drug debts and the stealing that he was doing to support his habit. He was about the worst I ever saw, snorting stuff about six times a day. “I have sinus issues,” he’d often claim with a straight face, as he fit the toothpaste cap to his nostril and threw back his head once again. One day I came back from work to find him frantically rummaging through his mostly empty locker, and crawling around on the floor.

    “What’s up?” I asked, somewhat reluctant to involve myself.

    “Someone stole a piece out of my locker,” he said, panicky.

    This was certainly possible, since the addicts always seemed to be taking anything they could get their hands on, especially from each other. But instead I told him, “You probably just lost it,” hoping for less drama. I also pointlessly reminded him that a piece looks a lot like a paint chip, and those are everywhere.

    Around that time I’d started composing a country song titled, “My Bunkie Is a Junkie,” but I found that not much rhymes with Suboxone. Now he’s in another housing unit, pulling the same stunts. Still, I can’t hate him for any of that, or for stealing some food from me to support his habit; it’s just too depressing.

    In my time in the jails and prisons in D.C. and Virginia, I’ve been astonished by just how many people are locked up for drug crimes or, it’s important to note, drug-related ones. Black, white, Hispanic, it doesn’t matter: In state prisons and local jails, 15 percent and 25 percent of inmates are there for drug offenses, respectively. In federal prison, it’s even worse: More than 45 percent of inmates are there on drug-related charges.

    That’s a mind-boggling number of human beings locked up because of their addictions, either directly or indirectly. Our response to this problem is to put them in prison, where they’ll get little to no help and have all the time in the world to sit around scheming about getting high.

    I don’t have some smart solution for all of this. Just like on the street, little works for people who don’t want to quit using. But I know that most of these addicts don’t belong in here. Trying to incarcerate our way out of the problem is not helping them, and it’s not making society any safer either.

    Because these people will all be out on the street again in a few years—and all they learned in prison was how to cheat and steal and hustle more creatively to get high.

    Daniel Rosen, 49, currently resides at the Greensville Correctional Center in southern Virginia, where he is serving a five-year sentence for computer solicitation of a minor. He spent 15 years working for the departments of State and Defense on national security issues.

    The District of Columbia Department of Corrections did not respond to requests for comment about allegations of drug use in its facilities. A spokesperson for the Virginia Department of Corrections declined to answer questions about the incident in which eight inmates overdosed.

    View the original article at thefix.com

  • In Recovery, on Suboxone, and in the Weed Business

    In Recovery, on Suboxone, and in the Weed Business

    In print and online, I preached cannabis. In life, I practiced therapy and Suboxone.

    I had a few days left on my Suboxone script when I interviewed Justin “Bong King.” He was a professional bong-racer and self-described champion of the competitive smoking circuit. An affable guy, nonetheless his was an image of American cannabis long past, pushed aside by marketing grads and stay-at-home moms who sold branded CBD and touted the benefits of micro-dosing. 

    But Justin drew a crowd, and an entourage to boot. And his natural talent for hitting the fastest gram of weed would corner me into compromising my recovery.

    Throughout my career as a cannabis journalist, I’ve kept silent about my sobriety. Finding freelance gigs is hard enough without the added burden of having to be that guy. Besides, if I learned anything from active addiction, it was how to lie at my job.

    Covering Cannabis Events and Lying About My Sobriety

    But as time passed, I felt withdrawn and disconnected. My recovery had no place in the cannabis industry. Moreover, medication-assisted treatment (MAT) seemed anathema to its goals, according to experts and the news. Rep. Matt Gaetz openly questioned whether buprenorphine and methadone are “a more effective offramp [to opioid use disorder] than medical cannabis.” CNN announced that CBD cures heroin addiction. And the editors of Leafly figured out how to combat the opioid crisis with medical cannabis two years prior.

    After 20 years, recovery had finally become routine. As a cannabis journalist; as an editor in chief — so had my lies.

    Some lies were easy. Weekly therapy appointments usually coincided with editorial meetings or deadlines. I worked from home, my boss was lax, and anyway, I kept hours around the clock. Monthly visits to my psych and 30-day Suboxone refills upped the number of undisclosed appointments I logged, but still, no one seemed to care.

    On assignment was a different story. I covered cannabis expos or dispensary openings — events where the drug laws were lax and the supply was liberal. At a hotel in Hell’s Kitchen, I spent three nights alone avoiding networking galas and after-parties hosted by music moguls turned industry entrepreneurs. In the world’s largest dispensary off the Las Vegas strip, I dodged more questions than I asked when leaving empty-handed. With hand waves and head shakes and less-than-assertive no’s, I passed over pot by lying about my sobriety.

    But face to face with Justin “Bong King,” there was nowhere to hide — no hotel room to run to, no door from which to make a quick exit. There was a crowd around us, boxing us in as he finished his gram smoking demonstration. I shook his hand and stumbled over my words as I signed off the segment on camera.

    It was either a contact high or placebo effect, or maybe just panic anticipating the piss test I would take in the next few days.

    Intensive Outpatient: 12 Steps and Scoring Drugs

    When I had about two months left in my treatment program, I walked out of group for good. It was an intensive outpatient program; a six-month IOP run by Philly’s NHS that championed the Big Book and 90 days. For a minute it worked, but it’s drug rehab mired in a puritan past. The 12 steps are great, but they shouldn’t be a front-line defense.

    Besides, all I did there was make friends and score drugs. Thirty addicts in a room is an excellent opportunity to network and learn.

    By Easter Sunday that year, I felt broken. I was in a dirty motel on Route 1, hopped up on Benzedrex cottons and a $60 baggie of hex-en I purchased online from China. After 20 years of addiction, I had no drug of choice, save for anything that made me high.

    My wife and kids back home slept together in one bed, a little less worried than the last time I disappeared. I was out of work and estranged from everyone. My best friend joined AA and realized I was one of his people, places, and things.

    All I had was my family, and I was losing them too.

    One lie allowed my addictions to grow without the worry of what would happen tomorrow. It’s the lie I told myself when I stole my ex-wife’s Dilaudid two days after her shoulder surgery. It’s the lie that made me laugh when I snorted enough Adderall to make my nose blue. And it’s the same lie that made me indignant when my ex-girlfriend’s brother became angry that I was a sloppy drunk in front of his small children.

    On the Monday after Easter, I drove home before sunrise. It was dark and muggy and difficult to see through my tears and dilated pupils. When I got home, I faced my wife and children and ended the lie that had followed me through two decades of addiction.

    “I can’t stop,” I whispered. That week, I discussed MAT options with my doctor. I’ve been in recovery since that day.

    Cannabis as the Magic Bullet for the Opioid Crisis?

    Tyler Sash won the Super Bowl in his rookie year with the New York Giants. At the time, he didn’t know he only had a few years left to live. A sixth-round draft pick out of Iowa, he overdosed on a combination of methadone and hydrocodone at the age of 27.

    “[He] asked if he could smoke marijuana for his pain like the other players,” recalled his one-time girlfriend, former Miss Iowa and reality-show contestant Jessica VerSteeg. I interviewed VerSteeg when she was promoting a new blockchain-bitcoin something-or-other product in the cannabis space. She recounted Sash’s tragic tale during our interview, explaining how it became the backbone of her business.

    “I wanted to change the way that other people saw cannabis,” she said.

    VerSteeg’s article drew in readers, as did most CEO and celebrity interviews. Her story reminded me of how lonely my secrecy about my recovery had become. I often wished I could reach out and say that I understood. There are millions of people with substance use disorders, and we’re all so alone.

    But like most of the executive class in the cannabis industry, her hot take on opioids ended up being bullshit. Conventional wisdom in the cannabis industry had run somewhat amok on this topic, and it forced me, I felt, into compromising everything.

    There was the DEA agent who was so disgusted with opioids that he became a cannabis executive. Without irony, he told me that more research would prove the plant’s medicinal value. The head of an “innovation accelerator” in my city held a conference on the role of medical cannabis in the opioid crisis. He quoted research showing that states with medical cannabis laws have lower rates of opioid overdose deaths. Cannabis, they were convinced, would solve the opioid epidemic.

    But Where’s the Evidence?

    “Morphine, when it was introduced, was promised to cure what they called alcoholism at the time,” Dr. Keith Humphreys told me. A professor of psychiatry and behavioral sciences at Stanford University, he’s also worked at the White House Office of National Drug Control Policy under Presidents Bush and Obama. “Then, people got addicted to morphine, and cocaine was introduced.”

    He continued: “In general, there’s been this enthusiasm of if we just add a different class of addictive drug on top then that will drive the other addictions out. Generally, what happens is we get more addiction to that drug, and we still have the original problem.”

    I spoke with Dr. Humphreys after reading his research on cannabis laws and opioid overdose mortality rates. Contrary to conventional wisdom, he found the correlation to be spurious at best. It’s alarming — though not unsurprising — to see the industry ignore his findings. Several states, including Pennsylvania, where I live, approved opioid use disorder as a qualifying condition for medical cannabis.

    “I couldn’t recommend something medically without clinical trials, well-controlled by credible groups [and] checked for safety,” Dr. Humphreys said. He explained that in the case of cannabis, there was little more than these state-level correlational studies. “None of that has been done.”

    “I’m amazed and disappointed that we don’t care more about people who are addicted to heroin [and other] opioids, that we would wave through something like [medical cannabis] without making sure that it will help people, not hurt them,” he continued, noting that cannabis has shown no efficacy as either a replacement for or an adjunct to any MAT therapy.

    Listening to Dr. Humphreys made me realize how little I stand up for what I believe. Sometimes, when you’re an addict and you lie so much, you lose any sense of truth.

    Tyler Sash’s family asked Jessica VerSteeg to stop using his name to promote her business. According to a report in the Des Moines Register, they didn’t want his name associated with drugs anymore, neither opioids nor marijuana. VerSteeg refused, repeating the story she told me to several news outlets.

    For two years, I wrote about and reported on the emerging cannabis industry while hiding my ongoing recovery. In print and online, I preached cannabis while practicing therapy and Suboxone.

    Even in recovery, you can still have regrets.

    View the original article at thefix.com

  • Outreach Vans Increase Sobriety, Survival For People With Addiction

    Outreach Vans Increase Sobriety, Survival For People With Addiction

    The mobile outreach program provides Suboxone prescriptions, syringe exchange, health screenings, disease management and other free services for individuals who are homeless and struggling with addiction.

    The CareZONE van in Massachusetts is providing treatment and hope to those with addiction who are experiencing homelessness. Funded by The Kraft Center for Community Health at Massachusetts General Hospital and the GE Foundation, the goal of the program and the van is to bring preventative health care, addiction treatment, and harm reduction services to any person with addiction who wants it.

    There are only six or so of these mobile treatment programs around the country, testing the effect of their services on the rate of overdose and recovery in the community.

    The CareZONE van provides an impressive range of free services, including in-patient detox, medications for addiction treatment (such as Suboxone), Naloxone (Narcan), syringe exchange, health screenings, disease management and more. 

    WYBR reported that the CareZONE team consists of experienced outreach workers, doctors and case managers. Dr. Jessie Gaeta, chief medical officer with the Boston Health Care for the Homeless Program, works with compassion and patience as she earns the trust of her patients.

    “We’re trying to let people know we’re not there to arrest them. We’re not there to clean up their encampment and kick them out,” Gaeta told WYBR. “All we want to know is, do we have something you need and want, and if we do, great, here it is. And so we gradually build a relationship that way.”

    If the patient is willing, Gaeta treats infected injection sites, checks for heart and lung infections (common with certain drug addictions), and offers vaccinations as well as buprenorphine (the active ingredient in Suboxone), a drug that reduces opioid cravings. If Gaeta believes the patient may have a more serious condition, she requests that they come back to the van for a more extensive check-up.

    According to those involved, the CareZONE van has been successful. WYBR reported that in its 18-month lifespan, 316 prescriptions for Suboxone have been supplied from the Care Zone van, and 90% of them are filled, with 78% of those being refills.

    Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University, told WYBR that he believes this could be a solution. 

    “Once [they’re] in every county in the United States, there’s a place somebody can go and get started on treatment for free, that same day,” Kolodny affirmed, “that’s when we’ll really start to see overdose deaths come down, significantly.”

    View the original article at thefix.com

  • 7 Things I Wish I Could Tell My Parents About My Addiction

    7 Things I Wish I Could Tell My Parents About My Addiction

    Here, on this motel floor, I need to know that you still love me. If it isn’t too painful for you, please visit me in rehab. When I tell you that I’m finally ready to get clean, please believe me even if it’s the 100th time.

    I constantly find myself in conversations with both of my parents about that dark time in my life. In the beginning of my sobriety, I tried to explain to them about opioid receptors and dopamine levels but it never seemed to make a difference. Many parents have a “You did this because you are weak!” mindset. They think that you can just quit. Well, Mom…

    1. I Can’t Just Quit

    I’ve been tired of this life for a long time and I have the desire to be the person you once trusted. But every time I quit, I get sick and believe that life just isn’t worth living. I’ve tried to get clean but once the fog clears I realize how much I’ve damaged my life and I go back. I wish I could snap my fingers and be normal with a job and home, but my brain has changed. I want to be the child who you loved unconditionally but I’m not, I’m sick. I don’t like sleeping outside and going to rehab every few months, but that’s what this drug has done to me. It’s a part of me now and unless I have it I can’t even get out of bed. I hate myself and what I’m putting you through, but my mind and body are broken right now.

    2. This Isn’t Your Fault

    This didn’t happen because you left me to cry it out in the crib for too long or because you weren’t strict enough. There isn’t a recipe that you followed to make me a drug addict. This happened because I tried something out of curiosity and my brain and body responded in a way that made it impossible to stop. Ever since that first time, my brain hasn’t worked the same. I am not lazy, stupid, or weak. I wish that I could sleep this off with a hot shower and an iron-rich diet but it doesn’t work like that. It started off as fun, but now I’m trapped.

    3. My Addiction Shouldn’t Be the Topic of Gossip

    I wish you could tell all your coworkers that I graduated from that expensive university we planned on me attending. I know you aren’t proud of me right now, but I’m still a person. I want you to heal and be able to talk about how much I’ve hurt you, but please don’t use me and my addiction as entertainment. I am still your child.

    You might not know much about how addiction works but I need for you to keep my most embarrassing secret close to you. Your coworkers and distant relatives don’t need to know that I’m in jail yet again. My great grandmother that lives a thousand miles away doesn’t want to hear about how I am living in a dirty motel. Unless I’m a threat to them or their belongings, I ask that you protect my dignity. People assume the absolute worst about people like me and I’m not proud of anything I’ve done to feed my addiction. Along with getting high, I have engaged in degrading behaviors and even exposed myself to disease and violence.

    When people hear, “My child is a drug addict,” they think about every negative thing they’ve ever seen in a movie or heard on the news and they will apply it to me. Why would you even want to share these awful things? Talk about the president or what movie you just saw instead. When I get better, I will have to face what I have done and accept the mistakes that I have made. I will have to face the people that you shared my humiliation with. Please don’t think that I am asking you to suffer in silence. There are support groups and therapists who have the knowledge and skills to help you get through this, too.

    4. Try to Learn About My Addiction

    Did you know that the American Medical Association classifies my addiction as a disease? I didn’t make this up to make you feel sorry for me, it really is. I made the initial choice to start using drugs but when I wanted to stop, my brain said no. It made everything else in the world unenjoyable. Could you imagine not being able to enjoy your favorite piece of cake from the best bakery in town? This is my life right now. The chemicals in my brain have been reprogrammed to want one thing only.

    If you don’t believe me, and you probably won’t, take ten minutes and do a little research on addiction. While you are clicking on different links and learning about what I’m going through, please look at all of the different treatment options too. Did you know that there is a medication you can give me in an emergency that will reverse an opioid overdose at home? It’s called naloxone and you can get it from the pharmacy and it could possibly save my life.

    I know that you want me to get better. I do, too, but it’s much harder than just saying no. It’s important that you know that there are some medications available that can help my cravings and others that will completely block the effects of opioids. Whether or not these are what’s best for me is something I will have to decide on my own but you should know about them. As long as I am seeking treatment or have even talked about how I want to get better, I am still here fighting.

    5. I Have Suffered Through Incredible Trauma

    I have seen death and loss. I have lost my dignity and self-respect. Some of my friends have died because of these drugs and I have been close to death myself.

    I don’t know if I’ll ever be able to talk about the terrible things that have happened in my addiction because I know how much it will hurt you. You might say that this is my fault and that I’m weak, but I’m not. I’m in here fighting with these memories and still waking up in the morning. When I get clean, I will need time to heal. I will need counseling and even a little bit of space.

    6. I’m Sorry

    I’m sorry I stole from you and constantly lied to you. I’m sorry I didn’t make it to Thanksgiving last year, and I’m sorry you found me unconscious. I’m sorry that I made you cry. If I had a penny for every regret, I could pay you back for everything you’ve done for me. Right now, however, I would probably spend that money on drugs because I’m sick. One day I hope that you will forgive me. I don’t expect you to forgive me soon, but hopefully you realize that your child is still in here.

    7. Please Don’t Give Up on Me

    I’m not asking you to give me money, that ship has long sailed. I’m not asking you to let me come home or even to trust me right now. Here, on this motel floor, I need to know that you still love me. I need you to call me and tell me how you are. Please be a constant in my life, even if it’s just through text messages. If it isn’t too painful for you, please visit me in rehab. When I tell you that I’m finally ready to get clean, please believe me even if it’s the 100th time. If I tell you that I’m going to start taking medication to help with my sobriety, be proud of me! Don’t tell me that I’m trading one drug for another, because I’m trying.

    Just please, don’t give up on me.

    View the original article at thefix.com

  • Finding Recovery and Support for Opioid Addiction on Social Media

    Finding Recovery and Support for Opioid Addiction on Social Media

    The rules state: We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.

    Four years ago, Dorothy had no support for her opioid addiction. As a mother and stepmother, she was afraid to be open about her struggle; if her children’s father or stepchildren’s mother found out, they might question her ability to be a good parent. She thought about attending recovery meetings but was worried they would shun her for being in active addiction or, some years later, for taking Suboxone, a partial opioid agonist, to manage her chronic pain. Luckily, she discovered a private Facebook group that supported people like her with opiate addiction.

    For the sake of full disclosure, I’m also a member of this group. While I enjoy my social media fill of cats dressed in dinosaur costumes, babies getting slices of Kraft singles thrown at their heads, and I love dad jokes just as much as the next person, I value this group the most.

    Addiction Support…on Facebook?

    The group quickly became a refuge for Dorothy and me, a digital safe haven where we could share our pains and joys behind the privacy of a screen.

    “I have made friends that I’m sure I’ll have for the rest of my life. I feel supported and secure here. What I love the most is how diverse we are. We run the gamut from people who are using to people who are totally abstinent and everything in between… All we ask is that people respect each other and everyone’s path to recovery,” Dorothy said.

    After participating in another group where members were shamed for taking Suboxone or methadone to manage their opioid addiction, I found Dorothy and the group’s perspective on harm reduction refreshing. In order to join the group, members must agree that they will not bash medication-assisted treatment (MAT). According to the official group guideline: “We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.”

    Another administrator added, “If you hate the fact there are active addicts in this group, if you don’t support MAT or [you] want to be a douche canoe to everyone you meet who doesn’t live up to your standards, LEAVE.”

    After nine months of participating in this group, Dorothy became a volunteer staff member, then administrator. On an average day, she spends six hours involved in the various tasks that keep the group running. Dorothy, along with eight other administrators and nine moderators, approves each post before it hits the page, ensuring that the posts follow group guidelines. The guidelines mirror that of an in-person support group: members must maintain each other’s confidentiality and privacy, be respectful, and refrain from giving medical advice, selling or seeking drugs, asking for money, or posting links to treatment centers.

    Sarah Burbank has also been a volunteer group administrator for four years and spends four to eight hours on the group each day. Sarah considers the members of the group to be family. “The group is a touchstone and an inspiration. I have watched some group members pass away and have to announce to the group a loved one or cherished member has passed away from the disease. Those are the darkest of days. But there are little milestones that we share that make it so special. Day 1! 30 days! Years clean! Getting children back and jobs and lives back. Those are the truly beautiful things that keep me here.”

    Dorothy and Sarah are not alone. This particular Facebook group has blossomed to 22,000 members. Members are hungry to share their stories, to be supported, validated, and encouraged. Posts reveal a complex tapestry of emotions: of recovery, struggle, pain, joy, heartbreak, victory and defeat, often all in a single post.

    Using Social Media to Forge Connections in Marginalized Groups

    It may seem contradictory to turn to social media for support for addiction. According to a 2018 Fix article based on research from Penn State, social media use is correlated with increased rates of depression and loneliness. Similarly, in 2011, Researchers Daria J. Kuss and Mark D. Griffiths systematically reviewed psychological literature and found that social media can be used for connection, but also that it may negatively impact relationships, work, and academic achievement. This and other evidence suggest social media can be an addiction just like alcohol and drugs.

    While it’s important to acknowledge this research and the potential negative impacts of social media, this critique fails to recognize the power of online social networks, especially for marginalized people. Toronto-based mental health professional Krystal Kavita Jagoo says, “For some, authentic human connection may only come online. Sometimes you don’t have those options in person.” Jagoo pointed out that social media or internet forums can feel safer for people of color, queer, trans, and non-binary folks, and people of differing abilities.

    Jagoo continued, “If you’ve had a traumatic experience and are able to hear from others about things someone has struggled with, you don’t feel as alone. Sometimes it’s just knowing that others understand what you’re going through; they can offer strategies or things that have worked for them that you might be more inclined [to try] than a professional who doesn’t have lived experience.”

    Jagoo herself has found valuable support online. “I think of how healing it has been to connect with folks of color around the world with respect to surviving oppression.” In order to maintain balance in our lives and avoid social media burnout, Jagoo recommends finding a group that is anti-oppressive, accepting, and feels rewarding. Setting and maintaining boundaries is important, as is making sure that you only check notifications when you have time and energy to engage, and unfollowing or leaving groups if they are feeling more draining than helpful.

    Both Dorothy and Sarah mentioned that it is difficult to be a group administrator while balancing their work and home lives. But by far, they feel the benefits outweigh the challenges of spending hours volunteering in the group. “The online community is really important because it allows people to connect in the safety of their own homes, anonymously if they choose. It gives us the ability to reach so many more people, people that we wouldn’t have otherwise had any contact with.”

    View the original article at thefix.com

  • New Bill Aims To Deregulate Buprenorphine & Other Addiction Treatment Meds

    New Bill Aims To Deregulate Buprenorphine & Other Addiction Treatment Meds

    The proposed bill would remove the extra barrier that prevents all doctors from being able to prescribe opioid treatment meds.

    The movement to deregulate drugs that treat opioid addiction is gaining steam in New York with the support of 18 state public health directors and U.S. Rep. Paul Tonko, who will soon introduce federal legislation to make it easier for doctors to prescribe medications like buprenorphine.

    Currently, prescribers need special training and permission to give out addiction treatment drugs which they don’t need to prescribe opioid pain medications like oxycodone. The proposed bill would remove that extra barrier.

    “These professionals can use their training and skill and ability to provide medication for treatment of pain,” said Tonko to STAT News. “But when it comes to addressing the illness of addiction, they have to jump through additional hoops.”

    Buprenorphine, a major ingredient in medications like Suboxone, is an opioid initially designed to relieve pain without producing as many side effects as morphine. Though it is possible to abuse and become addicted to buprenorphine, opioid-tolerant individuals are generally unable to get high on controlled doses. It can therefore be used to treat cravings and withdrawal symptoms without getting patients high.

    Opponents have expressed concern that deregulation could result in an increase in diversion and misuse of these drugs. However, addiction experts say that most illegal use of buprenorphine and similar drugs is used to treat addiction rather than for recreation. If access to addiction-treating drugs is expanded, they argue, non-prescription use should decrease.

    “We want people to be getting medication from health care providers,” says addiction medicine specialist Dr. Sarah Wakeman. “The question with buprenorphine diversion is how you best reduce its non-prescribed use—and the answer is probably expanding access to treatment.”

    Less than 7% of health professionals hold the DEA waivers necessary to prescribe addiction treatment medications. Currently, physicians need to go through an extra eight hours of training in order to obtain these waivers, and nurses and physician assistants have to complete 24 hours of training.

    The lack of available prescribers means that even those who seek out addiction treatment may have to see a different health professional just to obtain a prescription for buprenorphine.

    In March 2019, two physicians published a call for the deregulation of buprenorphine, saying that it could save thousands of lives. They cited the example of France, which removed additional restrictions on prescribing opioid addiction treatment drugs in 1995 and saw an 80% decrease in opioid overdose cases in the following years.

    With opioid overdose deaths in the U.S. drawing close to 50,000 each year, even “just” a 50% decrease could save tens of thousands of lives.

    View the original article at thefix.com

  • How Suboxone Helped Me Until I Could Help Myself

    How Suboxone Helped Me Until I Could Help Myself

    I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed.

    Suboxone, while often controversial among addiction treatment professionals and people in recovery, has moved to the forefront in discussions about opioid treatment. The recovery community has no shortage of naysayers insisting that medication-assisted treatment (with drugs such as Suboxone, buprenorphine, and methadone) is simply trading one addiction for another, characterizing it as heroin in legal form and just another way for the big pharma companies – who are already blamed for the initiation of the opioid epidemic – to pull in profits. But Suboxone is not an illicit street narcotic with fatal overdose rates surpassing even automobile accidents, it’s a life-saving tool that many experts insist is our best hope for the current public health emergency.

    Medication-Assisted Treatment Is Effective, But Stigmatized

    According to Dr. Gavin Bart, Director of the Division of Addiction Medicine at Hennepin County Medical Center and Associate Professor of Medicine at the University of Minnesota, opioid addiction requires long-term management; behavioral interventions alone have extremely poor outcomes with more than 80% of patients returning to drug use.

    “Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function,” Bart writes. “Extensive research shows that each of the three available medications used to treat opiate addiction have superior treatment outcomes to non medication based therapies. Increased retention reduces mortality, improves social function, and is associated with decreased drug use and improved quality of life.”

    Abstinence proponents may be skeptical about Bart’s research, but for me, it rings true. Reduction in illicit opiate use? Check. Decreased craving? Check. Improved social function and improved quality of life? Check, check. Abstinence-based treatment did not save my life. Medication-assisted treatment paired with specialized addiction therapy helped me save my own life.

    As an active member of the recovery community, I am mostly outspoken and typically very candid, even when it comes to mortifying revelations. And even for me, Suboxone is a touchy subject. I am more comfortable discussing random substances I’ve injected than I am discussing how Suboxone was a key player in my opioid addiction treatment. I think my discomfort is a result of the negative rhetoric that surrounds the medication, and ironically enough its harshest critics are often other people in recovery. The prejudice against medication-assisted treatment is harmful, and even deadly when the negative discussion derails someone from seeking the help that, according to the evidence base, may give them the best chance of staying alive.

    Is medication-based treatment the perfect fix to a horrific and increasingly deadly addiction? No. Suboxone has its burdens. I grappled with those too. When I first started taking Suboxone, I’d take it for a week and then relapse on heroin. I did that a handful of times before I was finally serious about getting clean.

    My Suboxone Journey: From Relief to Frustration

    My initial Suboxone dose was 8 mg buprenorphine with 2 mg naloxone. It was an orange strip with a tangy taste that I’d place under my tongue and wait while it dissolved into my bloodstream. Because I essentially switched directly from heroin to Suboxone (taking the first dose when I began experiencing opioid withdrawal symptoms), I didn’t have to suffer the weeks-long detox that frequently triggered my repeated relapses.

    Taking my daily dose of Suboxone was like a sigh of relief at the beginning: one more day that I didn’t have to suffer through withdrawal. But after a few years, the sighs of relief eventually turned into sighs of disdain. My once-considered reprieve from the consequences of my addiction was starting to feel like a rusty pair of shackles. I was sick of going to the doctor and refilling my prescription, I was sick of keeping this secret from everyone in my life, I was sick of being terrified to travel. This thing that had once made me feel normal now had me feeling like I was still, after so much time, tied to my painful past of addiction.

    Nothing else in my life reminded me of my past. There were no remnants of my previous addict self. I didn’t associate with any of my old using friends, I hadn’t seen or spoken with any dealers in ages, I never even got pulled over for traffic stops. I didn’t look like a junkie anymore and I didn’t act like one either. I had nurtured and repaired the ties with my family, I had a loving, healthy relationship, and I was well on my way to getting a college degree. I had successfully restored myself to sanity, as good ol’ Bill would say.

    Fear kept me stagnant, which didn’t feel fair. I had come so far and was nothing like the junkie I once was, but I still had this inevitable withdrawal from Suboxone hanging over my head. My one final detox. The big whopper. How would I go through with it? I was in school so I couldn’t miss two to four weeks of classes, and anytime a summer or winter break neared, I’d chicken out, despite telling myself it was time and trying to prepare for it. In the meantime, I’d slowly been cutting down. I went from the initial dose of 8 mg buprenorphine/2 mg naloxone strips to 4 mg/1 mg, and then even further to 2 mg/.5 mg.

    Suboxone Withdrawal

    I had no idea what to expect. Like many of us, I have some form of post-traumatic stress disorder from my time in active addiction, and a major part of that was the horrendous withdrawals. I was completely fixated on these impending withdrawal symptoms, and there was nothing I could do — I had to pay the debt.

    I finally made the decision to go through with it. I made the appropriate arrangements and was prepared to suffer for a couple weeks minimum, several weeks or maybe even months maximum. I watched YouTube to try to ease my frazzled nerves, but the videos pacified my anxiety like a game of Russian Roulette. Do not watch YouTube. Some videos had people detoxing, drenched in sweat and sobbing into the camera and others had people after just a week saying, “Not so bad guys!”

    The night before I took my final dose, which was a teeny tiny square cut from a buprenorphine 2 mg/naloxone .5 mg strip, I curled up into the fetal position, buried myself under my duvet and cried myself to sleep. I couldn’t believe I was about to enter junkie limbo after living as a functioning member of society for so long.

    The first few days weren’t pleasant, but it was nothing like I’d experienced in the past. I couldn’t sleep, I tossed and turned, I had tingling chills and clammy sweats, general anxiety and a sense of unease. I once detoxed from a $100 a day heroin habit and it was like I was the star of an exorcism horror film; compared to withdrawals like that, this one wasn’t nearly as bad as I’d anticipated. I think spending so much time tapering down to as small a dose of suboxone as I could handle really paid off when it came time to detox.

    Another big fear I had, mostly thanks to Google and YouTube, was post-acute withdrawal syndrome (PAWS). After the initial detox, the last time I felt any symptoms I knew were directly related to my withdrawal was about a month and a half after day one. I had a mini-panic attack when Target was too crowded. I started pouring sweat, rushed to my car, and burst into tears. And after that, I’ve simply felt normal. That thing we all desperately want to feel: “normal.”

    What If?

    The detox was tough, it was emotionally taxing and physically draining. But I realized that it was the fear of the withdrawal that had me suffering the way I was. It was a fear of the symptoms and a fear of the unknown. I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed. I did deeply introspective work in therapy and I changed my social environment, all while using Suboxone. I built up my self-worth by investing in myself and investing in healthier relationships, things I never could have done while still using heroin. I fixed my broken coping mechanism, I knew how to handle stress and sadness. Yet, there was still this tiny sliver of me that wondered, “what if?”

    What if it was all some magical mask that Suboxone created and none of this was reality and as soon as I stopped taking it I would revert to my old tormented life?

    That is what prompted me to finally write this piece — realizing that regardless of the discomfort I feel discussing Suboxone, there are other people in recovery using medication-assisted treatment right now, scared to talk about it and scared to get off, experiencing the exact same fears that plagued me. Once I made the leap and decided to go ahead with my final detox, and then when it was complete, I felt free. Finally free. Not because Suboxone had me stuck, but because Suboxone helped me move past the hardest time of my life. This withdrawal was the final chapter to that saga and it was finally over — and I survived.

    I closed the book, I’d won the war.

    View the original article at thefix.com

  • Virginia Eases Suboxone-Prescribing Restrictions

    Virginia Eases Suboxone-Prescribing Restrictions

    The policy change will increase access to the medication and reduce delays in treatment.

    Prior authorization will no longer be required for Virginia physicians to prescribe a form of the opioid addiction medication, Suboxone, to patients.

    The state’s Department of Medical Assistance Services (DMAS), which oversees the Virginia Medicaid program, has removed the authorization requirement for  Suboxone film (a film applied to the tongue). Suboxone is a brand of buprenorphine that assists individuals in reducing or quitting their dependencies on heroin or prescription opioids.

    Acting chief medical officer of the DMAS, Dr. Chethan Bachireddy, said in a press release that his agency has “a responsibility to understand and to meet the needs of our members and the providers who treat them.”

    Before the policy change, Virginia physicians were required to obtain prior authorization from DMAS or one of its contracted health plans to prescribe Suboxone film.

    According to the Virginia Mercury, the change will increase access to the medication and reduce delays in treatment.

    The Virginia Mercury also cited a recent study by Virginia Commonwealth University that found that the expansion of Medicaid—approved by voters in 2018—will provide as many as 60,000 uninsured Virginians with access to treatment services for dependency issues, including 18,000 with opioid dependency.

    In all, 400,000 Virginia residents are expected to gain access to coverage in 2019.

    Data culled from the office of the state’s chief medical examiner in January 2019 found that 1,229 Old Dominion residents died as a result of opioid-related overdose in 2018—the same number of fatalities that occurred in 2017. However, the total number of 2018 fatalities will not be available until this spring.

    The revision of the authorization requirement applies only to Suboxone film, but not to other forms of buprenorphine that are not on the Medicaid preferred drugs list.

    But buprenorphine, often in conjunction with counseling, has proven to be effective in lowering death rates among those who have suffered a previous overdose. The DMAS press release cited a study that suggested that among overdose survivors, there was a 40% decrease in the death rate of those who used Suboxone, compared to those who did not.

    Bachireddy described the revision as one of several “effective, proactive strategies that are putting Virginia at the forefront in the fight against the opioid crisis.”

    View the original article at thefix.com

  • "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    Dopesick Nation explores addiction treatment and the thin line between interventionist and client, recovery and relapse.

    Note: This piece contains spoilers for Dopesick Nation

    As a former social worker in recovery from addiction, I was initially skeptical of the VICELAND Series Dopesick Nation because I thought it would follow the familiar formula of A&E’s Intervention and TLC’s Addicted. I was wrong. Dopesick Nation is different from these other shows for many reasons, but it’s especially good at illuminating the unique difficulties of being a recovering addict while also working with and helping other people struggling with addiction. Dopesick Nation explores the thin line between interventionist and client, recovery and relapse. This is a common struggle, as 37 to 57% of professionals in the addiction field are in recovery themselves. Due to stigma, there is sparse data on how often people working in this field relapse, but I found a preliminary study that found 14.7% of addiction treatment professionals relapse over their career lifespan. I can relate: I’ve relapsed twice while working in the field.

    Let me start by saying that I commend all people working in addiction and recovery treatment. While I have mixed feelings about Intervention and Addicted, I have deep respect for the interventionists who have made it their mission to help people with addiction while also navigating the daily struggles of their own recovery. The traditional interventionists of Addicted and Intervention appear so stable; each of their stories follow a typical trajectory from drug addict to helper. On the opening montage of Addicted, interventionist Kristina Wandzilak says: “By the time I was 15, I was addicted to drugs and alcohol. I robbed homes, I sold my body, I dug in dumpsters to pay for my habit. Today I am an interventionist…”

    Yes, Wandzilak and the other interventionists’ stories are all inspiring to people like me in recovery, but the reality is that many of us relate more to Dopesick Nation’s leads, Allie and Frankie. Both are candid about the difficulty of working in the field and later Frankie is open about his relapse. But we’ll come back to that.

    Addiction Treatment on TV: Intervention, Addicted, and Dopesick Nation

    One of the first stark differences between these shows is the more relatable, down-to-earth way that Allie and Frankie approach their clients. From my experience as a social worker with eight years of experience in the field, I know that the first step is building rapport and earning the trust of vulnerable people who are skeptical of helping professionals. Allie wears yoga pants and hoop earrings, Frankie is covered in tattoos and wears a backwards black hat and a t-shirt with the logo of his nonprofit, “FUCK HEROIN FOUNDATION.”

    This may seem surface level, but first impressions matter. Trust should be earned, not expected. I had a client who refused to open the door to staff for weeks, in part because she felt social workers were elitist and unrelatable. When she finally let me in, she said, “You’re not one of those preppy ass bitches.” My boss joked that all the staff should get tattoos, a lip ring, and blue hair like me even though technically it was against dress code policy.

    In Addicted and Intervention, the interventions are staged in the carefully controlled environments of beige hotel conference rooms. Wearing business casual clothes, neatly ironed polos and chinos, the interventionists sit on comfy chairs in a U-shaped circle, then conduct a carefully orchestrated, seemingly scripted intervention.

    In Dopesick Nation, Allie and Frankie meet their clients where they are, which is a foundation for building a helping relationship. The show takes place in sunny, touristy Florida, where glimmering sandy beaches are dotted with tourists in Hawaiian shirts playing shuffleboard next to the swirling tides of the turquoise ocean. But Allie and Frankie don’t meet on the beach. Instead, they talk to clients on park benches, and curbsides in bad neighborhoods, braving torrential downpours and scorching heat. This method of “meeting people where they are at” is supported by years of social science research and was a cornerstone of my work as part of an outreach team to help people with severe mental illness and addiction. We left our office bubble, braving blizzards and arctic cold, because we knew clients were more likely to go to detox or another facility after a course of meetings in their homes.

    Fast forward to Frankie admitting he’s relapsed and is taking Suboxone, a medication to deal with opioid cravings. Wringing his hands, itching his sweat-glazed skin, Frankie tells his sponsor Gary: “90 to 95% of my day helping other people find their recovery. Sometimes I’m not taking care of my own recovery. And how am I gonna help other people get something that I don’t have? A lot of people rely on me, that pressure weighs on me.”

    Gary encourages Frankie to go to detox. “When you’re working in treatment, you’re around sickness all day long and you’re absorbing it… You need to work a righteous program.”

    Treatment Professionals Who Relapse

    I want to tell Gary that even though Suboxone is sometimes shunned by the recovery community, many studies support its efficacy. Suboxone is a valid form of recovery. I want to reach across the screen, hug Frankie and tell him he deserves the same care and compassion that he gives to clients, that it’s okay to take a break from the field to take care of himself. I want to tell him that I admire him even more because he let his guard down and was honest. I want to tell him that more of us relapse than he may realize and assure him that he is not a hypocrite for relapsing and taking Suboxone. I want to tell him my story.

    Three years ago, I was working at a day center with people who had struggled with homelessness and addiction. I remember one day when a client who was an IV heroin and meth user told me about his struggles to get clean. My years of experience taught me the art of self-disclosure, specifically if and when it was appropriate to disclose to clients that I too was in recovery. Since I’d known him seven months and even been trusted to store his dead cat’s ashes (a story for another day), I told him about my addiction as though it was in the past tense, although it was very much in the present tense. Steeped in denial, I told myself that my nighttime and weekend benders wouldn’t bleed into daytime. Looking back, I feel ashamed, but I know that denial is also a powerful drug. For a while, I thought I juggled my work life and secret life well. I thrived at my job, until, surprise— the benders bled into my work days.

    One day this client told me he was worried about me. He’d noticed my weight loss, blue circles under my darkened eyes, and change in personality. That’s when I knew I needed help. It was time to take a break from being a social worker. I went to detox for five days, then resigned and decided to move home. Like Frankie in Dopesick Nation, I realized that I couldn’t take care of others until I took care of myself.

    Eighteen months later, I miss social work and helping people. I hope to one day return to the profession, but in the meantime I’m using writing as a means to fight the stigma of addiction and shame of relapse. The reality is that relapse rates vary between 50 to 90%, and even treatment professionals are not immune to the realities of addiction. My hope is that one day more helping professionals like me can come out about their relapses and be commended for our honesty.

    What are your thoughts on Dopesick Nation and Frankie and Allie? How should people who work in addiction treatment make sure they’re taking care of their own recovery? Let us know in the comments.

    View the original article at thefix.com

  • How to Taper Off Suboxone: A Survival Guide

    How to Taper Off Suboxone: A Survival Guide

    “Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient.”

    Note: This article is not intended as a replacement for medical advice. This is merely the experience of 21 people interviewed by the author who have successfully tapered off buprenorphine-based medications (Suboxone, Zubsolv, Bunavail, Subutex, etc.) or significantly reduced their dose. Please consult your doctor before beginning a taper. 

    After two and a half years of taking Suboxone, I’ve decided that it’s time to start the tapering process. I don’t like having to rely on this little orange film strip each morning to get out of bed, the tidal wave of nausea, being constantly hot, the restless legs, and the constipation. This is an incredibly difficult decision because Suboxone has saved my life. Additionally, studies have demonstrated the effectiveness of Suboxone and found it’s reduced overdose death rates by 40 percent. 

    Some people decide that it is best for them to take Suboxone for life. Shannon has been taking 16 milligrams of Suboxone for 17 years and has no intention of tapering. She said: “I’m never getting off, why fix something that isn’t broken? I love life now. I’m a great mother, wife, daughter, sister, aunt, and trustworthy friend to all those that know and love me. I have absolutely no shame being a lifer. I’ve been to the depths of hell and now I’m in heaven. I believe without subs, I would be dead.”

    Like Shannon, fear of relapse and withdrawals makes me terrified of coming off Suboxone. I imagine waking up panicked and glazed in sweat, running to the bathroom to puke and worst of all, the black hole of depression and existential dread that is common with opioid withdrawal. These are common fears for people coming off opioid addiction treatment medications. In order to help others like me who are interested in tapering, I researched this topic and surveyed 21 people: 13 have successfully tapered off Suboxone and eight have significantly lowered their doses and are currently at or under six milligrams per day.

    Slow Taper

    Sixteen of 21 people I surveyed reported using a slow taper to come off or lower their dose. Dr. Jeffrey Junig of the Suboxone Talk Zone Blog suggests that the optimal dose to “jump” or quit taking Suboxone is .3 mg (about 1/3 of 1 mg).

    Junig writes: “I have had many patients taper successfully off buprenorphine. Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient. Tapering by too much, or too quickly, causes withdrawal symptoms that lead to ‘yo-yos’ in dose.”

    Amanda* agrees with Junig’s advice not to try to jump from too high of a dose. She said that when she jumped from 2 mg cold turkey it was “40 days of hell.”

    To avoid a hellish experience like Amanda’s, Junig advises reducing your dose by 5% or less every two weeks or 10% every month. Sound confusing? Junig simplifies: Use scissors to cut half of an 8 mg film. Then cut half of that, then half again. Put the doses in a pill organizer so they don’t get lost or accidentally consumed by children or pets.

    Holistic Remedies

    There are a handful of holistic remedies that can help with the tapering process. Folks I surveyed said that yoga, meditation, and healthy eating are pillars of their recovery. Studies have confirmed the benefit of yoga for improving quality of life in those withdrawing from opioids as it alleviates anxiety, restless legs, insomnia, and even nausea.

    Sarah said: “I tapered with a clean diet with digestible nutrient-dense food and smoothies and stayed hydrated. I got plenty of sun, used yoga and exercise too.”

    Others recommended vitamins and other supplements including: L-Tyrosine, DLPA, Vitamin C, Omega 3 Fish Oil, and ashwagandha. They used melatonin for sleep and Kava tea for relaxation. (Consult your physician before taking any supplements. Even benign substances may interact with other medications or have unintended side effects.)

    Marijuana

    Four out of 21 people polled used marijuana to deal with the difficult side effects of tapering off Suboxone. Barry said: “I know that some people may not see marijuana as a way that should be used to taper, but for me I was desperate to try anything that worked. I consider marijuana a lesser of evils. It helped with restless legs, nausea, pain, and anxiety.”

    Marijuana may now be a viable option for those who wish to try it, because it’s now legal for medical use in 29 states and for recreational use in nine states plus Washington DC. Unlike opioids, marijuana provides pain relief with a lower risk of addiction and nearly no risk of overdose. Plus, comprehensive studies like this one from the American Pain Society found that medical cannabis use is associated with a 64 percent decrease in opiate medication use.

    While studies have supported the use of marijuana to reduce opioid use, further research needs to be done as reported in the The Daily Beast. Dr. Junig also advises that patients should not start new mood-altering, addictive substances in order to taper off Suboxone.

    CBD Oil

    Three of the Suboxone patients polled were able to taper with the help of cannabidiol, also known as CBD oil. Experts emphasize the distinction between marijuana and CBD oil: CBD oil is not psychoactive, meaning that it doesn’t make patients feel “high” like the THC in marijuana. CBD oil may be a more viable option for people in states where marijuana has not been legalized and also for those who do not want mood altering affects, but strictly relief from physical symptoms. “I used CBD oil during the taper because pot isn’t legal in my state and it helped with restless legs, sleep, and anxiety,” Pablo said.

    A 2015 study in Neurotherapeutics examined the therapeutic benefits of cannabidiol as a treatment for opioid addiction. They found that CBD oil is effective in reducing the addictive properties of opioids, mitigating withdrawals, and lessening heroin-related cravings. Specifically, it relieved physical symptoms such as: nausea, vomiting, diarrhea, runny nose, sweating, cramping, muscle spasm. Additionally, it treats mental symptoms like anxiety, agitation, insomnia, and restlessness. The study states CBD oil is effective with minimal side effects and toxicity.

    Kratom

    In our survey, the people who tried kratom claim that the herb is a controversial yet effective way for tapering from Suboxone. Some experts agree. According to the Mayo Clinic: “In Asia, people have used kratom in small amounts to reduce fatigue or treat opium addiction. In other parts of the world, people take kratom to ease withdrawal, feel more energetic, relieve pain, or reduce anxiety or depression.”

    Four of the individuals surveyed used kratom for tapering off Suboxone. Christine said, “I was very tired when coming off Suboxone, so kratom helped give me the energy to work, clean my house, and take care of my kids.”

    Cristopher R. McCurdy, PhD, a professor of medicinal chemistry at University of Florida’s College of Pharmacy in Gainesville, studies kratom. McCurdy told WebMD: “I definitely believe there is legitimacy to using kratom to self-treat an opiate addiction.”

    Despite these positive reviews, the Mayo Clinic and Web MD caution that kratom can also lead to addiction and withdrawal. According to an article on WebMD, “There’s little research on the herb’s effects on people, and some experts say it also can be addictive. The herb is illegal in six states and the District of Columbia, and the Drug Enforcement Administration is considering labeling it as a Schedule I drug…For now, the agency calls it a ‘drug of concern.’”

    Pharmaceutical Remedies

    Five of the people surveyed said that they tapered with the support of medications prescribed by their doctors to treat individual withdrawal symptoms. It is best that patients talk with their doctors and addiction professionals to see if a particular medication is right for their situation.

    Happy tapering! I plan on writing more in the future about my experience and progress tapering off Suboxone. If you’re embarking on this journey, I wish you luck!

    The names of some individuals have been changed to respect their privacy.

    Have you successfully tapered off Suboxone or methadone? Or are you a “lifer” like Shannon? We’d love to hear your thoughts, experiences, and tips in the comment section.

    View the original article at thefix.com