I'm going to a Suboxone doctor tomorrow to get started on it. When I spoke to the doctor on the phone he said I have to take a drug test tomorrow at my first appointment. Is there a certain outcome of the test that I need to get a prescription for Suboxone? Like, do I have to fail to prove I'm addicted to heroin or do I have to pass? If anyone knows it would really help me because of right now I won't pass a drug test for opiates.

Im not sure I was wondering the same thing. When my tax check comes I am going to the suboxone doc to get a script they told me it was $400 plus the script cost.

Don't they want you to come in full w/ds too? I am calling a non-profit rehab place tomarrow that offer suboxone and methadone therapy to see if I can get it cheaper from them, I tried calling just now but they are only open from 5am-2pm.

Nobody cares about your fucking pathetic play by play daily life in real life, or on the internet.

Congrats on your decision Blaze! I've been on Sub for a few years now (On and off) and as a rule of thumb, they do want to see a positive opiate screen on your first urine/drug test to make sure you're not just trying to get a script to sell/abuse. It's like this at Methadone clinics too.

Also, you need to be in moderate to moderately severe withdrawals in order to be given your induction dose of Suboxone (Which should be under your doc's supervision to make sure no precipitated withdrawal symptoms occur or worsen). This usually means you need to be off any short acting opiates (Heroin, IR Oxycodone, Vicodin, IR Morphine, etc.) for at least 24-48 hours, allowing your body to enter withdrawal during your initial visit so that Suboxone (Buprenorphine) does not throw you into PWD's (Precipitated withdrawals), but actually help alleviate your existing symptoms instead. If you are coming off of long acting opiates (Methadone, ER Oxycodone, ER Morphine. etc.), you need to wait up to 5 days (Off of the drug(s)) before you can be safely inducted on Suboxone.

So my advice would be to take a Vicodin or Percocet or snort a bag of H two days before your Suboxone appointment, if you haven't done so in the past 2-3 days already. As bad as this sounds, the doctor will 9.9 times out of 10 deny you a script and induction into a Suboxone maintenance program if you do not show up in withdrawal or more importantly your drug screen comes up negative for opiates (Because of the fact they will think you are doctor shopping/getting a script to sell). Though obviously, you will want all of your other future drug screens to be negative for opiates and positive for Buprenorphine (Suboxone); and my doctor does this every time I see him/get a new script AND most doctors DO check to see if the Suboxone is in your urine and that all other opiates are not; some even refuse to give you another script if you show up positive for any other opiate or negative for Suboxone, but most would give a fair warning because of the nature of addiction and relapse being so fairly common.

Anyway, hopefully I have answered your questions. And if you have any other questions about Suboxone or what not, please feel free to ask. And if you still have my AIM screen name, you can always get me there (Haven't changed it).

If you need anyone to talk to about your future plans and what to do from here, I've been there and will be more than happy to help! You're such a strong person for making this choice and I know you will succeed!

Take care and be safe!

djONE.

PS: If interested, there is a GREAT board of people in recovery on Buprenorphine maintenance that I have been a part of for a couple years now at NAABT.org that you should at least check out and read, if not sign up and post away! An absolute priceless mine of information on the topic!

Suboxone has really helped me with my Heroin addiction, I have been on it for years.

hows that helping?


but yea they want a positive screen..

heroin will show up in urine after 2 days off the stuff?

Well if you're going to get it prescribed specifically to get off opiates then I would think you would need to show pos to get it. It wouldn't make sense to want a clean test; if you were able to go long enough to give a clean test, then why would you need the stuff?

I think it's like methadone clinics where you have to prove your addiction to heroin by going there the first time in withdrawal.

Isn't the purpose of suboxone so that you can be weened off it, rather than have methadone sustain you indefinately?

mike

Isn't the purpose of suboxone so that you can be weened off it, rather than have methadone sustain you indefinately?

exactly, even if a 31 day taper..

Noway man, I can't even imagine living without it.

Isn't the purpose of suboxone so that you can be weened off it, rather than have methadone sustain you indefinately?

mike

Actually no. The purpose of Suboxone varies from person to person. Buprenorphine (Subutex/Buprenex) can be used for pain; it can also be used on the physically dependent (For opiates) to help transition and taper off; though it's much different for one who is addicted. You can't just switch to Suboxone from your DOC or Methadone, then start a 30 day taper and be cured. You, along with your doctor will determine what they think is best; and just like Methadone, Suboxone is used AROUND the world for opiate replacement therapy, just like Methadone. Why would Suboxone be touted and advertised for use in addicted/opiate dependent people, and then only be used exclusively for 31 days? In case it's news to anyone else, ADDICTION IS A LIFE-LONG DISEASE, there is NO CURE and it's something that once you have/trigger, it's with you until you take your last breath.

Don't mean to be offensive, just wanted to try and draw a clearer picture for those that may not understand the concept fully :)

djONE.

Heroin can show up in your urine for up to 5-7 days depending on how frequent and heavy of a user one is. Though most opiates, if you use them recreationally and infrequently, will be out of your urine completely in 3-4 days (For short acting opioids like Heroin, Oxycodone IR, Morphine, Hydrocodone, Codeine, etc.); however long-acting opioids (Like Methadone, LAAM, Buprenorphine, Oxycodone ER, Morphine ER, etc.) can be detected for much, much longer.

djONE.

Ace, I know you said you have to be in withdrawals to get the Subs but I did my last half a bag very early this morning because I was in so much physical pain due to withdrawals. Since I did a very small amount and my body is so used to high amounts of dope, would you think that by the time of my appointment at 4 PM eastern time I'd be in withdrawals again? I know yesterday I did some in the late morning and by dinner time I was already shaking and showing symptoms of sickness. I just don't want to go and have the Doc to tell me to come back in a few days because that's such a living hell. I don't want to have to go through it again without some sort of medication to relieve the symptoms.

How much does Suboxone normally cost? I know the Doc I'm going to said it costs $200 per visit and you start off at 1 visit a week until stabilized and then go to one visit a month after that. He also said my Blue Cross Blue Shield health insurance will cover the cost of the Suboxone medication itself. I just didn't know if that was a normal price for a Doc or not.

Hey Blaze,

Firstly, what I said about having to be in withdrawals in order for you to be "inducted" is partially correct; I did want to clarify. Obviously if you have gone 7-10 days without heroin (Or any other short acting opiate) and already gone through withdrawals, it's still okay to get onto Suboxone (As a maintenance medication for fear and prevention of relapse) without any ill side effects. Though if you try to take Suboxone while still physically dependent on any other opiate, you will be immediately induced into precipitated withdrawals, which is 10x worse than withdrawing naturally since it throws all the symptoms and pain at you in a 4-6+ hour period, instead of the normal 7-10 days, NOT FUN! This is one of the reasons you want to be in withdrawals or over withdrawals before you even attempt to dose with Suboxone; so it can fill the receptor sites as the old opiate you were using is leaving them, instead of having to rip them off aggressively/forceably and replace them. Another reason, is so the doctor can see that you were/are dependent on opiates and that you are suffering from it. But as said above, the exception would be if you had already gone through withdrawals, have relapsed [perhaps multiple times] in the past and do not want to continue this cycle; though this scenario is very rare for not only the patient, but also for the doctor to believe, because at the time after withdrawals, not only will you look "fine" to the doctor, but your urine screen will also come up clean for opiates, making the doctor believe you are just trying to get a scrip to sell.

I would think that only a half a bag of H after being off of it for at least a few days (Enough to be good into withdrawals) that 12 hours would be enough; but with that being said, if it were me, I would absolutely wait at least 24 hours no matter how little I did. On the other hand, it was a little amount, and heroin does have a very short half-life. Unfortunately, I can't tell you how it's going to turn out for YOU, but if for some reason, the doctor just gives you a script and doesn't make you take the induction dose at his office, then I would wait until tomorrow morning/very late tonight to take the first dose to make entirely sure that no precipitated withdrawals will occur; but like I said, heroin has a very short half-life, and you should absolutely be in at least moderate withdrawals by the time of your appointment this afternoon. And if you are at least in moderate withdrawals (Chills, sweats, runny nose, etc.), then I wouldn't worry about it, you should be all set.

And as far as the cost is concerned, the price of the actual visit will vary from doctor to doctor. Some will take insurance, some will not. For me, I also have Blue Cross (PPO Select) and my visits only cost $15-20 per visit, but most Suboxone doctors now-a-days only want cash "because they can".

As for the price of the actual medication, without insurance, Suboxone is about $8 per pill, whether it be 2mg or 8mg pills. As far as pricing with insurance, my Blue Cross plan only covers office visits and no meds, so I have a seperate card/program for that called "Medco". The price for Suboxone with that plan is $25 per fill; meaning it's $25 for 1 pill or 120 pills. Each time I fill a prescription [or refill] of Suboxone no matter what the quantity of pills, it costs me $25.

I would imagine it would be around the same for you, no more than $50. But BE 100% sure that your Blue Cross plan does include prescriptions, because not all do. And if the case is that your plan does not cover scripts, if you have an AAA card, use that; it actually gives you a very generous discount [for most all meds].

Good luck and lemme know how the appointment goes!

Take care and be safe!

djONE.

addiction is a life long disease. dependency is not.

Fuckin' a-men. Subs are used to overcome the physical dependence and therefore avoid the related physical withdrawal; it's not made to be a life-long crutch to keep you away from dope. That's going to depend on your willpower and internal strength.

You don't see recovering alcoholics using some kind of medicine for the rest of their life every time they run into a psychological craving to go get fucked up. They get through it by psychological means and willpower.

If someone thinks they need Suboxone for the rest of their life in order to stop themselves from using heroin, then don't even bother quitting the fuckin' dope, because your willpower is obviously non-existent and relying on a tablet to keep you from shoving needles in your arm is just as sad as relying on that needle to get you through your day in one piece, physically and mentally.

If it's for pain that's a different story, but a lot of addicts use more for emotional pain than physical. Not if you ask them, though; if you ask them then they're ALL in physical pain, so severe, in fact, that they NEED some kind of opiate to overcome it. Even the ones in 100% perfect health.

Eh, I'm ranting/raving so I'll STFU. This topic can be a sore spot for me...

Fuckin' a-men. Subs are used to overcome the physical dependence and therefore avoid the related physical withdrawal; it's not made to be a life-long crutch to keep you away from dope. That's going to depend on your willpower and internal strength.

You don't see recovering alcoholics using some kind of medicine for the rest of their life every time they run into a psychological craving to go get fucked up. They get through it by psychological means and willpower.

If someone thinks they need Suboxone for the rest of their life in order to stop themselves from using heroin, then don't even bother quitting the fuckin' dope, because your willpower is obviously non-existent and relying on a tablet to keep you from shoving needles in your arm is just as sad as relying on that needle to get you through your day in one piece, physically and mentally.

If it's for pain that's a different story, but a lot of addicts use more for emotional pain than physical. Not if you ask them, though; if you ask them then they're ALL in physical pain, so severe, in fact, that they NEED some kind of opiate to overcome it. Even the ones in 100% perfect health.

Eh, I'm ranting/raving so I'll STFU. This topic can be a sore spot for me...

Actually, Mr. Crack man,

First of all, how can Buprenorphine be used to "avoid the related physical withdrawal" if it is an opiate itself? Buprenorphine (And Methadone) are both used to "put the withdrawal symptoms and drug seeking behavior on hold" so that you can get back to/resume a normal life without having to rely on taking a pill or shooting up every hour or the second you have a craving to do so. Yes, it may also be used as a fast [28 day] taper to get the physically dependent through a hard time, but for addicts, as both myself and viibe said, it's a lifelong disease; therefore, the cravings and relapses will never subside completely, they may only become manageable. Suboxone is there to help control those cravings and relapses so that one can focus on enjoying life without drug seeking/other illegal behavior.

And the moment you discontinue use of any opiate replacement therapy, you take the risk of falling back into the deep, black hole from which you came. It has ABSO-FUCKING-LUTELY NOTHING to do with will-power, because guess what? If the key to stopping addictive behavior was someone who had strong will-power, then there would be no addicts and everyone who is currently an addict would have succeeded when they said to their selves "I can stop taking this whenever I want. I'm going to try to taper down tomorrow and be off by the end of the month".

Relying on a pill to help you from falling back into the active cycle of addiction may be "sad" but it's a hell of a lot better than relapsing and overdosing then dying like many do OR getting thrown in jail because of illegal activity done to get the drug.

Obviously you do not understand the entire means of addiction, for if you did, you would know how strong it really is, and that some people do need more than therapy and groups to help them get through the day; a lot of those people may become strong enough to eventually be successful without opiate replacement therapy one day, but a lot of people will not; and ask any body currently on Suboxone [or Methadone] maintenance and 99.9% of them will tell you, if they had the choice at this moment of stopping replacement therapy today without any chance of withdrawal, yet still living with their addiction (And chance a relapse that will continue on and off their entire lives either putting them in jail or underground), would they choose that or to stay on Suboxone for an undetermined amount of time and continue to lead their current, addiction suppressed, successful lifestyle; that they [99.9%] would choose the latter.

Now I'm not saying this is the answer for every addict in existence, but for those who have tried therapy, groups and sobriety and those not being quite enough, for at least 7 out of those 10 people, they will choose to stay on an opiate replacement therapy plan for an undetermined amount of time.

Thanks for reading!

djONE.

PS: Oh and by the way... there are plenty of alcoholics who take Antabuse on a daily basis to prevent them from drinking/the temptation of it.

you missed my point. addiction and dependencey are not interchangeable words here. they're two different things. sure i'm a heroin addict, but i'm also not dependent on opiods. see, big difference.

i'm with POC as this is also a very sore spot for me as well, you can easily be an addict for the rest of your life. you don't however have to keep feeding the dependency for the rest of your life. if your willpower requires you to take something to prevent you from using, then why quit using? you obviously don't want to. those that want to be clean will get clean. but i really fucking hate it when some twobit idiot on methadone/suboxone claims he/she is clean while their still dependent on opiods....





the whole point of methadone/suboxone is the fact that their long acting opiods with a proven dose to make tapering more easier than using your DOC. obviously any opiod can be used to taper down, but with heroin purity varies and no junkie is going to be able to afford a few grams to be able to taper succesfully down that way. if you can't put it down, sure your addicted, but your also dependent. miss one and your hurtin. see, you can be addicted, and just miss it all together, without being hurtin...

Yeah, vilbe sounds like he's on the exact same page and paragraph as I am with this.

Don't get me wrong, from a medical standpoint, I feel suboxone and methadone are great treatments if that's the ONLY thing that will keep that person off opiates, but nevertheless it is the lesser of two evils. It's still the simple fact of relying on a chemical to overcome some kind of uncomfortable feeling, and that's the entire basis of addiction in the first place.

I may not have ever been dependent on opiods but I've been dependent on benzos for quite a while and currently this is the longest I've ever been off from them (10 months now) so I do understand the aspects of drug addiction. I came off high-dose regimens about 4 or 5 times cold turkey and aside from the hell of the psychological withdrawal, I'm honestly extremely lucky I didn't wind up with a seizure or possibly even dead by doing so. (Which is dumb, by the way; NEVER come off high-regimens of benzos or alcohol cold turkey. It CAN kill you.)

As far as the alcoholics who take Antabuse, yeah, it stops them from drinking, but if they really feel it's the Antabuse that's keeping them sober/out of jail/out of a casket then they're still a slave to a substance and therefore are still addicted. Something doesn't have to be liable to causing a chemical dependency for you to get "addicted" to it. Dependent is a much better word, but you get my drift.

NA is a little bit different on how they view this but in AA they don't buy into any of the "alternative" treatments except in completely dire circumstances. I go to three or four meetings a week these days (court) and I know damn well that if they knew I take Adderall (even though I do so as directed) and use Kava Kava they would try to talk me out of it and give me a lecture about how I'm still "dependent" on those substances.

I guess I agree with you both some what on certain topics; but I also still stand by my beliefs as you do yours, though I respect everyone's opinion to which we are each entitled to.

And with that, I feel we should probably end this convo here since I'm pretty sure it looks like we've taken over poor Blaze's post hah :-\

Though if there's anything else you wish to discuss, we could always make our own thread (Kinda pointless at this stage haha).

Oh and speaking of Blaze, how did your appointment go? Hope all is well! Let us know!

djONE.

I guess I agree with you both some what on certain topics; but I also still stand by my beliefs as you do yours, though I respect everyone's opinion to which we are each entitled to.

Definitely. And I do understand where you're coming from, even though we don't agree 100% on the subject. Nevertheless it's refreshing to be able to share conflicting opinions on a topic with someone with some sense.

But yeah, enough thread-hijack.

Well for anyone wondering how my appointment went, it went very well. I was given 10 Suboxone 8 mg pills to last me til Friday which is my next appointment where I will get another script for another 14 pills (I'm supposed to take 2 a day.) The doctor is very nice and he thinks I'm a great candidate for the medication since I'm using it and in outpatient therapy weekly at the same time. I've been feeling better since I started taking it. He said I could take up to 2 pills a day whenever I wanted so I started taking 1 at night and one in the morning instead of taking both at once and not having them last all day.

The bad thing is that he doesn't deal with insurance so each visit is $200 plus each script of pills is a $40 co-pay with the insurance (Blue Cross Blue Shield.) I have to go for an appointment with him every week for a month or two and then I can go once a month. But luckily I have parents that want me to get better and can afford to send me to the Suboxone doctor. I know I'm blessed because I can guarantee that there are junkies out there who would turn their life around if they had a medication to help them but not everyone can afford it so I am a thankful person for that.

The only problem with the Suboxone so far is that I still have INTENSE cravings for heroin. All purely psychological but it still kills me. I can't stop thinking about setting up my gear and the whole preparation of everything and then feeling the rush. I just want to feel that again so badly but I keep taking my Suboxone because I know it will prevent me (or greatly reduce the effects) from getting high even if I got my hands on some dope. The doctor said Suboxone is supposed to get rid of all cravings but it hasn't done any of that for me. It just makes me feel better.

I was thinking about switching to Methadone because I've heard it treats the cravings. Does anyone know anything about that or how it compares to Suboxone?

Oh by the way... the doctor explained opiate addiction to me. He told me once you start taking opiates your brain creates more opiate receptors because it gets overwhelmed every time you take an opiate to get high. As you continue to get high more often you brain continues to make more opiate receptors. In normal people the normal amount of receptors are filled fine by normal endorphins but once your brain starts to create too many extra you become addicted. Your brain has to continue to receive opiates to fill all the opiate receptors to even feel normal at this point. The Suboxone fills the receptors and gives you time to slowly taper your dose so that your brain can get rid of the extra receptors but its a slow and long process. But eventually once you're off Suboxone and have been off opiates for a while your brain returns to normal. He just said it's an extremely long process but the younger you are, the faster your brain heals itself. I don't know if that's 100% true but that's what he told me and he gave me a Suboxone book about it. Just thought I'd add that.

well he's pretty much right...


endorphin production shuts down upon dependency, infact thats hows you become dependent. even with a ween, your body doesn't even start producing endorphins again until its noticed its not getting what it used to. however, production doesn't resume 100% back to normal for almost 2-3 months AFTER complete cessation of opiods.


i could be wrong, but i'm no doctor.