Change of Heart

I will admit to a change of heart over methadone. I have not changed my opinions about using it myself; I have written often about the unique action that a partial agonist like buprenorphine has at the receptor and there are different subjective experiences for buprenorphine and methadone. But I recognize that I am being hypocritical for calling the 'anti-sub' crowd out for their actions and at the same time putting down those who do well with methadone.

I used to get all wrapped up in the 'total sobriety' flag, and look down on those on methadone as somehow 'inferior' to me. That was really dumb. A couple things have helped me see the light. First, I have heard from so many obnoxious twelve-steppers over the past year that I have become less proud of my associations with those groups. Yes, they DID save my life-- twice!-- but they are costing lives by their current actions. Knowing about addiction, the numbers of people using, the dynamic that people go through on Suboxone, I have NO doubt that there have been lives lost due to the reckless comments of 'recovering people'. It used to be AA folks telling people to stop their SSRIs, causing needless depression, now it is NA folks telling people to stop their Suboxone-- causing relapse, and sometimes, death.

The point is NOT how 'clean' you are; the point is whether you are treating your illness sufficiently so that you can live, and so that you enjoy the one life that you have. There are reportedly bad methadone programs, just as there are bad Suboxone programs and bad AA groups. I encourage everyone to find the program that fits, and use it to survive. If you are unhappy in life, do the hard work of truly looking at yourself, and set the goal to change in the right direction.

Comments anyone?

There's so much anti-methadone sentiment, I had the impression that those who were on it were turned into zombies or were just looking for a way to keep using. I've met several people in recovery however on methadone and I've gotta say I wouldn't have had any way of telling without them letting me know. Even though I feel more comfortable with Suboxone because of the ceiling effect and lack of potential for abuse (I'm not sure I could handle a 30 day script of methadone to take as prescribed) I have to admit methadone does seem to work for some. I've kind of come to the same conclusion, if it works for people and can help them live a normal life again I'm all for it Laughing

So I agree with you Doc
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"If you're going through hell, ....keep going!"
-Winston Churchill

Hi guys....just wanted to check out the forum and thank Dr. Junig for inviting me to be a part of it!
I run a blog and I am part of an organization called Advocates for Recovery through Medicine-Maine (ARM-ME) which is mostly about advocating for patients who utilize medication assisted treatment (MAT) for opiate addiction. However, since it's looking like medications may become an important part in the future of all addiction treatment, I hope ARM will be involved in helping patients in treatment for any type of addiction.

My sign on is ARM-ME, but really anything I post here would be from me, Kristan, (the opiate addict in recovery) on a personal level.

The methadone forum is of particular interest to me because I have been in methadone treatment for five years now. I am doing very well on it and because I have been on a stable dose for four years, only go to the clinic twice a month (I could go only once per month, but I kinda like checking in more often),the hospital I work for knows EVERYTHING and I know I am still not ready to be off medication, I will probably be on it at least another five years.

Matt brings up a point that is at the heart of why I try so hard to get my personal story out and try to encourage others to do the same. When we hear about people on methadone we think indigent, junkie, dirty, homeless, zoned out and on and on-we think of the same things we think of when we think "heroin addict"....we think of clinics being sordid places where people hang about, nodding out and drooling all over one another. Believe me, I thought it all too. The reason we think it is because the only stories out there are the bad stories.....methadone has such a horrible rap that most of us that are on it and doing well, can not fathom the thought of anyone knowing we are on it. So we have to sit back and let the "bad" patients do all the story telling for us.

Because my superiors at work already know my whole story, I really had nothing to lose by stepping up and telling my story...so I try to do it whenever I find a willing ear to bend. Besides, I gotta admit to getting a sort of sick kick out of meeting people, letting them get to know me and then a while later tell them my story. I love to hear "I would never have guessed!"....because that is exactly how it should be! If your on methadone and people can tell the minute they meet you, it might not be the right treatment for you (or your treatment goals need to be re-evaluated).

For me treatment was (and is) about allowing me to live the life I planned for myself before addiction became a part of it....and methadone treatment has done that for me.

Thanks so much for sharing Very Happy

I really have started identifying more with MMT patients being on Suboxone, and while buprenorphine and methadone have differences the end goal is the same. When I first started thinking about getting into a treatment program I did a little research into MMT and it didn't take long to see that while methadone maintenance has the potential of helping alot of people, because of many times unjustified fear from the public, legislation has prevented adequate facilities from going up where needed. I know here in Indiana the few centers we have are clustered together in larger cities and they are usually pretty overcrowded as we had many individuals from Ohio and Kentucky coming into the state for treatment. Much of the public outcry has been from traffic problems around MMT centers. When legislation prevents new facilities from going up where they're needed of course they are overcrowded and cause traffic problems Exclamation

Apparently Kentucky and Ohio have more stringent rules than Indiana about testing for illicit drug use and while I think testing is a good idea I can't say I agree with kicking a drug addict out of treatment for being a drug addict! So we ultimately have alot of people from other states in Indiana MMT programs further compounding an already overcrowded system. Other critics cite how many have died from methadone overdoses when the majority of o.d.'s are from diverted pain medication not MMT programs. I think the many obstacles that MMT programs have faced is one of the main reasons buprenorphine was approved in the first place. I really think in the end we have alot to gain from working with one another Laughing

I think many would be suprised by how effective MMT programs could be if they were allowed to grow to meet need and weren't kept under such tight regulation. Either way I just hope more still suffering addicts can find treatment that works whether it be Suboxone, methadone, or 12-step programs. I couldn't stay in abstinence based recovery programs long enough to get it, without relapsing. Anyways glad to hear of the success of others Very Happy

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"If you're going through hell, ....keep going!"
-Winston Churchill

Last edited by ARM-ME on Fri May 15, 2009 12:15 pm; edited 1 time in total

Matt I have been writing LTE's to Indiana papers forever for exactly the reasons you listed. In fact just a year or two ago some legislative member got a real stick up his butt about methadone...and tried to limit doses, time in treatment, takehome medication for even the most stable patients.....OH and my favorite, every patient had to have a driver to and from the clinic. I never really understood that one, just because methadone takes about an hour to start to work after taking it....so the ride to and from the clinic wouldn't be an issue if someone was intoxicated on it...it would be after the person was dropped off at home and able to get in their car and drive away. Plus, pain patients pick up methadone at pharmacies every day of the week! Every clinic I know about has a policy of calling the police if a person they believe is intoxicated (on any chemical) leaves the clinic driving. Its the one time they will break confidentiality. For the clinic I am sure it's a liability issue as much as anything.

Unfortunately, Kentucky clinics are notorious for offering bad treatment. And I don't just mean being more strict with takehome medication, (which I am all for in the first year of treatment). I mean the clinics are in the "business" but known for not really believing in what they do? I mean they run the clinics in more of a punitive manner, rather than therapuetic. I believe treatment should be more about helping someone rebuild their lives....working with THEM to achieve the goals THEY want, yanno? Not just DO THIS OR ELSE!

I think Suboxone and Methadone patients can benefit a lot from each other as far as fighting stigma. Although I truly do understand why Subs patients might want to distance themselves from the methadone model. But because we get many of the same types of obstacles and hurdles, we can help each other....methadone may have the bad rap, but it also has 40 years of experience with stigma and Subs has opened up this whole new brave world in addiction treatment, a world where addiction is treated as the disease it truly is....instead of the step child to "real" treatment.

Thanks for welcoming me!

If you get a chance sometime, send me an email: mmhanna@anderson.edu I'd really like to get more active in making sure addicts have access to medication assisted treatment. I remember reading about some of the regulations they tried to push on MMT programs here awhile back that you were discussing and I have no doubt they would have gotten away with it had people not stepped up to challenge them. So if you have any ideas of ways I might be able to help out please let me know.
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"If you're going through hell, ....keep going!"
-Winston Churchill

i see this is a rather old post..
and i know i've shared on this before...
but anyway...

when i got clean, then went to a few meetings, then went on suboxone and continued going to meetings... i got a little bit of static on being on suboxone. i guess it seems like coincidence that the people i'm surrounded by don't have anything "ill" to say about suboxone, but i think i've chosen a good sponsor and have a good support system of people who don't care how i stay clean, just that i stay clean..
yes, i've heard people say this or that about "not really being clean", "you're still using", etc... and i definitely felt for awhile that i NEEDED to hurry up and finish up this suboxone thing, but after months of reading the suboxone forum, talking to people, and just some general self education and soul searching.... i feel good, my addiction is in remission, i'm getting what i need from NA, and from suboxone... why should i take one or the other from the equation?

i wouldn't consider myself a crazy twelve stepper.. but i attend meetings regularly, participate, work the steps, and do what i think i need to do. i don't understand why it has to be one thing or the other, and so i choose both. and quite honestly, i feel the work i'm doing on myself through the steps is helpful to me on dealing with the things i've lost and done and undone and screwed up during my active addiction. and i'm not so sure i'd be able to stay clean through suboxone maintenance alone.

does it have to be either the steps or suboxone? and does everyone need to know about it? and do i need to listen to people who ignorantly tell people to get off of it to be "clean for real"?

ever notice how those people have never taken it, know nothing about it, and are just riding the self righteousness train to relapse-ville? i sure have.

have a good night.
and be well.

jp

i know a few people in my area that do the same thing as me, and it seems to be working for all of us.

I guess what is most importand in one's recovery is their behavior. If they are still using heroin or non-opiates such as cocaine or alcohol, living on the street, financially irresponsible, slovenly or unhygenic, or underemployed. Perhaps their recovery could be suspect. Treatment based recovery can be a great tool but a trip to the local methadone clinic one can observe much of the dysfunction of the drug culture. Most of the people going to NA or AA meetings, on the other hand have been generally more successfull in their abstinence, therefore understandably they would criticize treatment based recovery simply because of high number of abuse that still occurrs at clinics. If we could see all the people who have failed at non-treatment abstinence perhaps we would get a clearer picture. Is there a forum where we are likely to hear these criticism of Meth/sub recovery?

ndc1963-
If you want to find anti Suboxone and Methadone forums, just start looking around online, they are here.

* I was really happy to see the doc posting this message. I am a firm believer that medication assisted recovery clients need and deserve their own support groups. I hated the fact that I had to go to AA/NA while in IOP Treatment, only to hear how I am not clean, not truly in recovery, etc. Like it isn't hard enough. I was aginst keeping my treatment a secret because I was proud of my choice, and I wanted to share my feelings with people who were addicted/dependent too. This was a major factor in my going to college to become an addictions counselor.I want to help others who are going through what I once did, so they can see that MAT is not bad or wrong, it is a method, among others.Nobody should be confused about recovery choices!
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"It is never too late to be what you might have been!" - George Eliot

gotta make this quick but Shelwoy I completely agree and I'm looking forward to when Suboxone and methadone maintenance can be seen by others as a means to both improve the quality of life of opiate addicts and more importantly keep them alive! There's nothing wrong with abstinence based 12-step programs at all but I have grown tired of how many in the abstinence based recovery programs look down on us. No one form of treatment is going to work for everyone and ultimately, in my opinion it's whatever keeps you clean. I've been to many 12-step meetings where those who claim to be above those who are utilizing medication to stay clean and yet those are usually the same people who claim to be more "clean" than those of us who have chosen treatment that includes medication and very often those people seem to be absolutely miserable. Anywho enough rambling....

Ndc just like to say that I think I would take my time tapering if I were in your situation. I've begun to realize there's no race and while I used to hope and dream about being "normal" and off all meds I started remembering I wasn't ever "normal". Having to take medication can be an inconvenience at times but to me it's alot less inconvenient than relapsing and having to start my life out from scratch all over again or having to go to sometimes 2-3 meetings a day because I really want to use. There's obviously nothing wrong with wanting to be med free and I wish you alot of luck but would encourage you to take your time and not force yourself tapering can even be done in a way greatly reduces withdrawal or pretty much makes it non existent. I'll keep you in my thoughts and I hope you have some ways to deal with the times when you want to use post Suboxone. We're all here to support one another so I hope you'll continue to let us know how you're doing Very Happy

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"If you're going through hell, ....keep going!"
-Winston Churchill

I have been on methadone for 7 years. I have NO cravings and NO desire to use. My life has done a 180 and I exercise, make money, - live life on life's terms. I love being sober. I don't have a 'warm glow' as many describe after dosing. I will admit, I did in the honeymoon stage. I don't nod like some and am compliant. There is a horrible stigma that goes along with this drug...e.g. Anna Nichole, Michael Neophite's Methadonia. Btw, that was a biased documentary, trying to expose the negative side of methadone, with a bunch of bozos doing 20mgs of xanax, shooting coke , etc...in conjunction with the methadone.

Because MMT is so old, and until recently only associated with herion addicts. IMO, 'new' addicts are scared and seek an alternative. The thought of standing in line with the 'bikers' makes them cringe. A setting in a doctors office with a take home script sounds so much more appealing to the ' professional 'type. Heck, any type.

Sure people sell it and there will ALWAYS be people that miss-use the drug. The same goes with subs-I know many people on subs that get off their subs to get high- only to have them to avoid getting sick again. They take a little 'vacation from subs' then go back to junk and vise-verse. It's difficult for one to do this when they are dependent on 100mgs of meth. IMO, that's a great advantage of meth over subs. I know drug dealers that sell subs for $20(8 mg)- this is common. We are talking about typical addictive behavior here that happens also with MMT. Because there are far more people on meth than subs, I believe the sub crowd has more education than the meth crowd.

Again, many 'professional', 'new' addicts think meth clinics are gross and the councilor's have limited knowledge over the disease and it is a big racket. I'm a big proponent of the disease model of addiction.. BTW.

Sorry for rambling and thanks for letting me vent. the point: Methadone saves lives just like subs. When used correctly, they are incredible tools for this disease. Lets not forget that MMT has it's place in opiate addiction and try not to bash it just because something 'new is out'.

AMEN! Can't we all just get along and do what works for us, whether that includes NA, methadone, suboxone. What's important is that we all get our lives back any way we can.
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Promise me you will always remember...You are braver than you believe, you are stronger than you seem, and smarter than you think!

*Christopher Robin to Pooh

I know this is a old thread but I just have to add something.

One thats been on both MMT and BMT, I see no difference in the two. Maybe on that MMT is full agonist and I think it dosnt have to change the receptor sorta but this is just how I felt. Both fed me the opiate so I didnt have to live dope free. Both made my life easier then shooting dope. Both I caugh a high on when I wanted to. I think sub was easier to live with while on it as it only took a 5 min md appoint to get my months supply...I had 4 different Sub docs and all the same.. 5 min for lots of $$$. Looking back... I did wean off meth easier then the wean from sub. I am beginning to think that sub might change the receptor a bit which would take longer to heal .... but that is just my guess.

I think both have saved lives... both have been abused. I am gratefull for both of them. I am also grateful of Ibogaine.. well more estatic about ibogain since it put an end to it all.

I was kinda supriize that Dr J even had the negative thoughts about meth.. glad he woke up though. Really.. we are all addicts and there is little differece from one addict to the other. We all depended on a opiate to survive in our end stages of addiction.
BMT and MMT is there for those of us who cant face life without the opiate. It does what it suppose to do, help keep us safe and productive in life. Dont get me wrong.. I am happy that my brain dosnt need the opiate to survive these days. But if there was no such thing as ibogaine... I know I would be on MMT or BMT to survive. Just couldnt muster the abiity to live without it till I had real healing. The only sad thing in my eyes is the lie that BMT will heal you. It didnt heal me but did help me survive. For what is avail in the USA.. MMT or BMT is really the only answer for us that can not face life with out an opiate.

I know that those involved in iboga dosnt trust our goverment with the plant. I think they rather it stay illegal to protect the plant. I can see that. Now that its avail in the USA with the underground... there is just another way for us addicts to get better.

You think people on suboxone (or methadone) "can't face life without an opiate"? That makes it sound like it has to do with one's character or their strength. Maybe you could elaborate on that before I say anything else.
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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.

Ibogaine interested me for a long time. Unfortunately my brain doesn't seem to like psychedelic drugs these days (trips seem to linger a bit too long), so I'll steer clear.

As for the "facing the world without an opiate" idea. I'd argue that everyone has the potential to face the world without an opiate in their system. It just comes down to motivation.

But I do agree. Methadone and suboxone really aren't that different. Full agonist vs partial agonist? Give suboxone to someone who is opiate naive and they will get stoned, potentially overdose and even die. Give methadone to someone who is opiate naive and the same things can happen. Withdrawal off methadone is supposedly much worse than buprenorphine. As I've come off both, I can tell you that's not necessarily the case. Buprenorphine withdrawal after jumping off 8-10mg cold turkey was an intensely rough detox for 12-14 days (much more difficult than heroin ever was, strangely enough). Jumping off methadone 70ml was difficult, but not as intense as buprenorphine. However it only started to subside after 30 days, and I was still feeling the odd "wave" of detox kick in 6 months after.

It seems like Reckitt do enjoy telling the world how much better Subox is than Methadone. I don't see it as "better" so much as "different". The main reason I chose suboxone over methadone this time around (despite suboxone interacting with some of my psych meds) was (a) I've got the kind of face that gets very droopy on any kind of full agonist. (b) Methadone makes me feel like an "old man" - even though I'm 28. (c) While I was on methadone, the thought of reducing my dose brought on more fear than when I was on suboxone. Hence methadone can be more of a trap for someone like me.

The people I've seen who've managed a reduction and jumped off the done have always been really motivated and generally started on a dose then gone down a ml each week. Mind you, that's only 2 people! Neutral

And they both augmented their smaller doses of methadone with alcohol until they became alcoholics. Something about methadone being a liquid?

She rides everyone one of your posts because you are one of those anti suboxone people who put people on bupe down every post you make. You dont insult people directly you try to be sneaky about it in the way you word it and we all see right through you. My guess is you can't afford to take suboxone anymore and are jealous of all the people in here who are fortunate enough to be able to stay on it and live happily while you have to go through life probably thinking about opiates constantly. I even wonder if you have an opiate addiction or not because no one who is on sub maintenance gets "pin point pupils" everyday and get "high enough to nod" like you claimed in your other thread, sounds like someone who A) doesnt have a habit and has no tolerance so taking a sub gets them high or B) you've never taken suboxone in your life and are just trolling this board with anti suboxone drivel.

Hey, Suboxowned- you just wrote what I've been feeling since capt. 1st post........... Mike

[quote Capt] and if I NEVER took sub before... why the hell would I bash it?

So are you saying that you are here to bash suboxone? Just wandering. Thanks!!
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"Drugs are nothing but a dead end street with no street lights"

Um, why would i want you too bash subs? I only ask you that because of what you said. Along with a lot of other things you have said while on this site. It would be great if you are here genuinely. Thats all i can hope for. If not, then it will eventually come out.
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"Drugs are nothing but a dead end street with no street lights"

Thats absolutely insane to say that i want you to bash suboxone!! Where did you get that from? I dont even know you other than what you have disclosed on this site. To say that i want you to bash subs makes no sense. And thats great that you dont need sub anymore. Congragulations!! The other stuff you talk about not being forgiven for is in the past. This site is to help people and if you have that help to offer then thats awesome!! Nobody is keeping you from doing that. But for some reason you seem to act like your above us because were using sub treatment for recovery instead of ibogaine. You make comments talking about how you dont need sub for your recovery(dont mark me word for word on that) and that were just jealous of what you have. Quite frankly, im just fine with who i am and where im at in life. Ibogaine is not for me as you say sub is not for you and that is ok in my book. Nobody has made comments about you for choosing ibogaine like the way you have sorta looked down upon us for choosing sub. All i say is, if your here for the right reasons then their shouldnt be any further problem, conflict or even discussion of any of this. Its done and over with as far as im concerned. If its talked about anymore its only gonna seem that you are not here for the right reasons.
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"Drugs are nothing but a dead end street with no street lights"

Not to hijack the thread, but something capt said hit home for me. Talking about pin point pupils on sub. I am on 8mg a day, 12mg a day if I'm using it for pain relief, but 95% of the time 8% a day. I DO get pin point pupils from suboxone. Just like I did on oxycodone, and heroin. This has caused me a number of problems with my fiance. First off, she does trust me, but it worries her from time to time. She always used to know I was on an opiate during my addiction by the size of my pupils. I have small pupils naturally, but they were literally non existence while on any kind of opiate. So she puts the two and two together, and sometimes askes me calmly if I had relapsed and when I ask why would she think such a thing, she'd refer to my pupils being small, just like they used to be. Some days they are a bit smaller. I voluntarily do a UA for her every couple weeks if she's any kind of suspicious but I just felt I needed to bring this up since there was some confliction with capt and another poster on this. I know suboxone is an opiate, but I can't have my fiance even thinking I may have relapsed due to suboxone pinpointing my pupils damnit! Sad

Back to the subject though...the way I look at it is...however you choose to get clean and off the drug which put you here in the first place, good for you. Whether it's medicated assisted treatment or other methods. In the end, in my eyes, it simply does not matter. I've been on suboxone for close to a year now. I have not even yet thought about stopping any time soon either. I look at my disease like diabetes and suboxone as my insulin. As long as it keeps my life moving forward and away from drugs, then let it do it's magic. It sure as hell saved me from death or jail, that's for sure.