Tag: Suboxone

  • Clean, Sober And Using Suboxone

    Clean, Sober And Using Suboxone

    Suboxone users deserve a safe space, in and out of the rooms. And we deserve to proudly call ourselves clean and sober.   

    It was pretty apparent when I began taking Vicodin for migraines that I was going to have a problem, but I was too ashamed and afraid to ask for help.

    On the outside, I was a working professional, undergrad student and hands-on mom.

    Beneath the surface I was deteriorating. 

    It wasn’t until my career was in jeopardy and many relationships broken that I finally admitted I was out of control and needed treatment. I learned the hard way: Secrets keep you sick. Addiction grows in the dark. 

    Today, as a nurse in long-term recovery from opiate and alcohol addiction, I’ve made an intentional choice to forgo anonymity and live “Sober Out Loud.” I advocate for everyone in recovery, especially healthcare professionals, using blogging, public speaking, and coaching to do my part to end the stigma.

    My hope is that talking openly will give others the courage to speak up early. That they’ll notice their decline and get help long before their careers and lives are in danger. Choosing to be open about my addiction also supports my healing. I find accountability, connection, and purpose in sharing my experience.

    It wasn’t easy in the beginning – I was terrified of being judged. The opposite has been true – even in the hospital I worked for. Even with colleagues who may have reason to look down on me. I’ve been met with abundant compassion and acceptance. 

    Except I still have one secret. There’s one disquieting fact I haven’t told many people. I’m flooded with fear that I’ll be exiled from the recovery community and excluded from meetings. Petrified that my integrity as a coach and writer will be questioned. And if that’s the case, then what’s my value as a sober advocate?

    There are others who have the same fears, and my silence validates the stigma. Recently, I heard on the radio about a young man who committed suicide. He was tortured by internal conflict; he questioned his sobriety. We share the same secret.

    For that struggling human being, and for everyone else struggling – It’s time for me to be completely open.

    “Hello, my name is Tiffany; I’m an addict and an alcoholic. AND I use Suboxone.”

    This isn’t my opening line when I introduce myself at meetings – nobody has to divulge their prescribed medications to the group, right? The answer’s not so clear if you use Medication Assisted Treatment (MAT).

    On one hand, I feel I shouldn’t have to add a qualifier to the already awkward label I use when attending certain groups. (In the program I regularly go to, we don’t use labels at all, but that’s a subject for another time). On the other hand, it feels like I must add the qualifier, otherwise I’m a fraud. I start spiraling: “Am I allowed to share? What’s my ‘real’ clean date? Can I pick up a chip on my birthday month?”

    In my first month of sobriety, newly on Suboxone, I readily shared at meetings and with a few sober friends. Completely unaware of my disgrace, and totally unprepared for the reactions, I wanted to swallow my words as I was assaulted by:

    “Do you think you’ll be on it long?”

    “You’re going to get off of it soon right?”

    ‘You’re still on an opiate.”

    “You’re still getting high though.”

    “You’re not actually clean yet.”

    “Well you’re definitely not sober. Don’t call yourself sober.”

    “Do what you’re gonna do but don’t talk about it here.”

    “You can’t have a sponsor until you’re done with that.”

    “We all did it without. We didn’t need medication to get clean. You’re obviously not serious – not strong – not determined enough. You haven’t done enough steps. You haven’t gone to enough Meetings.”

    “You’re not sober. Come back when you are.”

    I thought I was sharing success and hope. They asserted I was “cheating the system” and “staying in the game.”

    This inhospitable reception is the reason I’ve stayed silent, the reason I haven’t written about it in my own blog. I found myself avoiding meetings altogether, second-guessing my sobriety; debasing my worth and value in the recovery community. 

    Despite the booming increase in patients using Suboxone, popular opinion – especially in traditional 12-step programs – is that Suboxone treatment and “clean and sober” are mutually exclusive. Regardless of research showing decreased morbidity and mortality of medication-supported patients, and the success addicts are seeing as they put their lives back together, the underlying criticism persists:

    “You’re not CLEAN.” 

    If I’m not “clean” I’m still dirty. If I’m dirty, I must be worthless. And if that’s the case, what’s the point of trying to recover?

    It’s abhorrent that leaders in the recovery community perpetuate the degradation. At a local level, meeting facilitators model this disparaging behavior, despite literature clearly stating that a person’s medication is no one else’s business. (Read The A.A. Member – Medications & Other Drugs).

    Even trusted chemical dependency physicians tout their opinions, adding to the universal disapproval. Dr. Drew Pinsky stated on the podcast “Dopey” episode #124  “I’d rather have them on cannabis.” And though he concedes he’d be open to discussing short-term use with patients to “get them in the door”, he says that Suboxone patients  “replace” other opiates and are merely surviving; that they are “not fully recovered” and “still chronically ill.”

    Still chronically ill? Not fully recovered? In the 3 years since I initiated a Suboxone regimen, I’ve worked tirelessly at making amends. I’ve regained my job as an acute care nurse and clinical instructor in a nursing program. I facilitate Recovery Meetings, and I’ve transformed into a certified Life and Recovery Coach. I’ve repaired relationships with family and friends.  I’m traveling, writing, and above all – finding JOY in living. I’m not an outlier. There’s thousands of us. We’re just not  allowed the safe space to share. 

    MAT is NOT perfect. I’m aware of it’s flaws and have experienced some of them myself. Anyone considering it should carefully review all potential side effects with their physician and trusted, non-biased recovery support. Suboxone causes physical dependence, and there’s severe withdrawal if one quits cold turkey. It is, chemically speaking, an “opiate.”

    Some prescriptions are diverted; I’ve personally cared for patients who admit getting the drug on the street. And with full transparency, I sometimes feel conflicted about using pharmaceuticals to overcome an addiction to pharmaceuticals. I’m not oblivious to the irony. And I strongly assert that any MAT is only truly successful if taken while simultaneously working on recovery of the mind and spirit. 

    But people are dying. We don’t have time to argue over which is the most righteous recovery path.

    After weighing all the pros and cons, searching my soul, and utilizing critical thinking skills I’ve honed in 17 years of working in healthcare, here’s what I’m absolutely sure of:

    Suboxone is right for ME.  I am Clean and Sober. 

    Four years ago I was resigned to being found dead in a bathroom with a needle in my arm. Today, I prove that recovery is possible. I am on a journey toward physical, emotional and mental wellness, and have a quality of life I couldn’t have dreamed up. Suboxone, for now, is a part of my story. As it is for many, in increasing numbers every day.

    Whether I wean off in a month or stay on it forever has no bearing on my credibility.

    It’s likely that someone sitting next to you today in a meeting is on Suboxone. It’s also likely they’re petrified to talk about it, like I was, and might leave the meeting fighting the humiliation of being “unclean.”  

    They might decide that it’s better to go back out and use, since they don’t belong in recovery; or to wean off without a doctor’s supervision, undergoing agonizing withdrawal and back at risk of using street drugs- which is part of my story as well. They might even decide that they don’t belong here – at all. That the only choice is to end their life. 

    What is your role in this? Are you hurting or helping? Consider the language you’re using. Is it pejorative and shame-inducing? Or do you cultivate love and belonging? 

    Those of us in recovery have a responsibility to welcome everyone who is making positive progress towards a sober lifestyle. It’s not our business to take the inventory of someone else’s medication list – it IS our business to eradicate stigma. Offer compassionate acceptance. Keep an open mind. Suboxone users deserve a safe space, in and out of the rooms. And we deserve to proudly call ourselves clean and sober.   

    Next time someone shares with you that they choose to use Suboxone – or any MAT – as part of their journey, don’t criticize. Don’t interrogate or give them a timeline to stop it. Ask how it’s working, and If they’re happy. Ask if they’ve been successful staying off street drugs; if they’ve made strides towards repairing the damage of their past. And when they share with you their clean date, congratulate them on being SOBER. 

    Tiffany Swedeen, RN, BSN, CPC/CPRC is a certified life and recovery coach, She Recovers Designated Coach, and a registered nurse in recovery herself from opioids and alcohol. Tiffany lives “sober out loud”, proudly sharing her story through advocacy and blogging and is passionate about helping others do the same. Her goal is to eradicate shame and empower all to live a life of radical self-love. You can reach Tiffany through her blog www.scrubbedcleanrn.com and follow her @scrubbedcleanrn. 

    View the original article at thefix.com

  • Buprenorphine Exposure Affects Kids At Alarming Rates

    Buprenorphine Exposure Affects Kids At Alarming Rates

    The number of children exposed to the addiction drug rose 215% over three years. 

    As the opioid crisis continues to grow, some children are being put at risk as they are exposed to buprenorphine, an opioid medication used to treat opioid use disorder. 

    A new study published in the journal Pediatrics found that from 2007 to 2016, more than 11,200 calls were made to poison control centers in the U.S. with concerns about children being exposed to buprenorphine. Of those, 86% were about children under age 6 and 89% were unintentional exposures. 

    “This is never prescribed for children under 6. It is a significant risk to them,” Henry Spiller, director of the Central Ohio Poison Center and an author of the study, told CNN. “We’re not quite sure why it stands out so much. Perhaps the parents who have this may not think it’s as risky as their other opiates because it doesn’t have the big effect that the other opiates do for them.”

    Of the 11,275 children exposed to the medication, the overall exposure rate per 1 million grew by more than 215% from 2007 to 2010. It then decreased 42.6% from 2010 to 2013, before increasing again in 2016 by 8.6%.

    Dr. Jason Kane, an associate professor of pediatrics and critical care at University of Chicago Medicine Comer Children’s Hospital, tells CNN that the increase in exposure has to do with the increase in adults using buprenorphine as a treatment option.

    “This is not the first study to show these data, but it is the latest study to show a medication whose design it is to help adults with narcotic or opioid addiction is ending up poisoning, mostly unintentionally, children and in particular those who are most vulnerable,” Kane said. 

    Buprenorphine is an opioid receptor stimulant as well as a blocker. It is considered an opioid but does not have the same effect as other opioids for adults, thought it can still be habit-forming. For children, however, it can have a stronger effect on the respiratory system.

    “In adults, the respiratory depression, the part that slows the breathing and you stop breathing, is limited, and so there’s a lot less respiratory depression in adults,” Spiller told CNN. “That’s why it was felt to be safer. Unfortunately, in very young children under 5, preschoolers, toddlers, infants… that protection isn’t there, and they do get this respiratory depression. It does affect their breathing.”

    Of adolescent exposures, 77% were intentional and more than one-quarter used the medication with another substance. 

    “It was surprising that adolescents were actually using it for abuse. It’s very specific,” Spiller told CNN. “You have to be in a program to get this. It’s carefully managed. It’s not widely available… It is available on the street, but essentially, the majority of this is from these management programs and someone’s in therapy, someone in the house, them or a family member.”

    According to CNN, study authors expect the number of exposures to continue to increase.

    To limit exposure, Kane recommends disposing unused medications, using child-proof caps and making sure medications are labeled correctly.

    “Seven children under the age of 6 died as a result of an accidental poisoning from this drug, which was present in someone’s home, prescribed with the goal of making someone else better,” Kane said to CNN, adding, “that’s a striking thing for me.”

    View the original article at thefix.com

  • Medical Schools Focus On Addiction Medicine Training In Light Of Opioid Crisis

    Medical Schools Focus On Addiction Medicine Training In Light Of Opioid Crisis

    Medical students are seeking out addiction medicine training and schools are making adjustments to fulfill their needs. 

    The opioid crisis is changing the way some medical schools are approaching training, according to the San Francisco Chronicle

    At the University of California, San Francisco (UCSF) School of Medicine, this is being done by implementing a yearlong fellowship in addiction medicine, the Chronicle reports. 

    The fellowship program is funded by the city and county of San Francisco and works to incorporate addiction medicine into overall medical training, rather than just psychiatric medicine. 

    Dr. Hannah Snyder is one of the fellowship participants and is expected to complete the program this month. 

    “I started learning about treating addiction and realizing we had highly effective medications to treat addiction,” Snyder told the Chronicle. “I got really excited about that because there’s a way to prevent people from having those complications in the first place.”

    According to the Chronicle, Snyder works at Ward 93 as part of the fellowship. Ward 93 is a methadone clinic at San Francisco General Hospital. There, she meets with patients to discuss treatment. 

    Snyder is also assisting other U.S. hospitals with new protocols for treating those with opioid use disorders. The Chronicle states that this “primarily means getting patients started on buprenorphine or methadone—two long-term prescription medications for opioid-use disorder—when they come to the hospital after overdosing or having severe withdrawal symptoms.” 

    The fellowship at UCSF School of Medicine isn’t the only one of its kind. In fact, since 2011, 52 U.S. addiction medicine fellowships have been accredited by the Addiction Medicine Foundation

    Fellowships are typically completed by doctors who have already finished their three- to six-year residency in a specific area and wish to take part in more training in a subspecialty, the Chronicle notes. It wasn’t until 2016 that addiction medicine was recognized as a subspecialty. 

    Dr. Anna Lembke, a psychiatrist at Stanford School of Medicine, is working to add addiction medicine courses to Stanford’s curriculum. 

    “It’s the dawning awareness within the medical community that addiction in general is a growing problem in our patient population,” she told the Chronicle. “The opioid epidemic has put it front and center in a way that gives people permission to focus on it. Suddenly there are research dollars available to study it, and federal grants. It has momentum it never had before.”

    At Stanford specifically, students are the ones pushing for additional education in the area. The Chronicle states that Alexander Ball, a fifth-year medical student, partnered with Lembke to create lectures centered around pain and addiction for first and second-year students. Some were incorporated into courses this year, and more will be next year, the Chronicle notes. 

    The lectures concentrate on opioid prescribing, administering buprenorphine and other medications and motivational interviewing, which is a counseling technique. 

    At UCSF, buprenorphine training has been offered as optional for residents and faculty since 2011, the Chronicle reports. Buprenorphine is used to treat opioid dependence and is a Schedule III narcotic, meaning doctors have to complete eight hours of training and get a waiver in order to prescribe it. 

    According to Dr. Scott Steiger, associate professor of medicine and psychiatry at UCSF, the buprenorphine training is drawing more and more medical professionals. 

    “Last year, we had to turn people away because we had reached our capacity for the room, which was 77,” Steiger told the Chronicle. “The next one (this spring), we had it in an auditorium to fit all the people. It’s telling that people are trying to get as much training as they can.”

    View the original article at thefix.com