Suboxone study

Hi, came across this and thought it was, well, depressing.

Article on suboxone treatment study from Archives of General Psychiatry

Thoughts? I find the <10% clean rate after suboxone taper very depressing. The results regarding counseling did not surprise me.

From what I'm reading, it looks like the longest anyone was permitted to stay in this study and on Buprenorphine was 4 months. That seems like a relatively short time to be on Buprenorphine, IMO. A lifetime of addiction can not be "cured" in 4 months. For those with shorter addiction histories, 4 months may be fine, but the article doesn't specify what kind of addiction histories the participants had, at least not that I saw.

Another thing, it seems like once a drug addict relapses, we're thrown into the idiot bin again. It's seen as a complete failure.

I still don't agree with the whole notion that once we addicts in recovery relapse, we're considered failures or that a relapse is considered a complete and utter failure. Not picking my happy ass back up and getting back into recovery would have been a failure.

How many of these people in this study relapsed once and got right back on the horse?? How many relapsed twice and got back on the horse, etc. That's what I really want to know. That's where true success and failure are measured, IMO.
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I'm with ya there Romeo.

There are heaps of factors not taken into consideration. 4 months is definitely not long enough to prove one's self is ready to get completely off opioids.

But even if the figure really was about 10%, is it really that surprising? The general consensus is that when an opioid addict stops taking all opioids, around one in ten remain abstinent. These people were opioid addicts who had stopped taking all opioids, even if their last drug was buprenorphine.

Am I the only one who sees a one in ten chance as quite promising? All it means is you gotta want recovery more than 9 other people who try. And I know a shitload of people who are half-assed about getting clean. And even if a person does slip up, laws of probability state that every time they try again their chance increases.

I think persistence is the key in this game, and not giving up on giving up. There are heaps of ex-opioid addicts out there who aren't on any kind of maintenance.

I'm with you both. This was posted on another thread and I commented there. There is also the fact that they put the subjects on sub for 3 months and tapered them off in only 4 weeks? I imagine the subjects had a miserable taper, withdrawl and paws. That is not a recipe for staying off opiates. To be honest I am surprised that 10% remained clean with this time frame.

It seems to me that the general public is convinced that we are hopeless. I feel good about myself and what I have done to change my life, until I read something like this. I am going to just keep on with my recovery and not pay attention to such studies.

There are very few diseases that are as complex and deeply woven into every facet of a person’s life as addiction. Suboxone is a godsend to many addicts; but, there isn’t a drug out there today that can deal with all of the physical, psychological, and social problems/symptoms created by the disease of addiction. Even though it can’t do it on its own, Subs work wonders when they are combined with group therapy, one-on-one counseling, and other forms of cognitive behavioral therapy; however, they must be given a chance and they sure as hell aren’t effective with such a short duration of treatment provided by this study. Coupled with the fact that the addicts in this study were there because they “wanted the medication,” this study was doomed to fail from the start.

When it comes to the mindset of an addict who is entering treatment, many of us would agree that, whether the person wants helps or is being forced to get help, the will to want to be clean plays an influential role in the success or failure of treatment. Therefore, shouldn’t there be some control for this variable, or maybe researchers should stop worrying about the generalizability of the study and find out who, how and why it works in the addicts that have success on subs. In my opinion, due to the aforementioned complexity of addiction, it would be within the best interest of society to develop and promote studies that show the true potential of buprenorphine, as fundamental piece of recovery, instead of those that will only worsen the general publics’ view of ORT with buprenorphine. A study like the one I listed below seems to be a prime example of what is needed.

http://sloark.com/slodrugs/Documents/Article%20Suboxone%20in%20Office%20Setting%202007.pdf

wow'. i give suboxone treatment a big plus in a way. and of course when they gave them a short term recovery and it still beat AA.NA. at 5% recovery rate
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this study was flawed from the get-go. such an incredible lack of foresight on the part of the researchers amazes me.

imagine you are an addict who is struggling financially with a bad heroin habit. they offer you a chance to participate in this study for a fee for 4 months. I would be thinking to myself: sweet, I get to "get my habit under control" for a few months then once they pay me I'm going to start again, but pace myself with some moderation management or something of that sort. that'd be my thoughts at BEST! the worst addict, the one less willing to change would just look at the participation compensation that they pay you as some free dope-money!!! they're not WILLING to change, they're not completely surrendering, they have NOT hit rock-bottom. see ya next detox is what my counselor used to say to people like that.

One should have no difficulty in seeing the faulty, distorted setup of this study and completely disregarding any conclusions/numbers that it produced.

i would have to share 12step2-24's frustration with the difficulty of finding properly constructed studies and legitimate research that takes into account all of the addicts' ulterior motives. social scientists can't "think" like an addict notwithstanding all their academic knowledge on the matter. The grimy, self-seeking, ego-driven behavior of an addict is hard to account for let alone prevent.

okokkkk im getting a little off track. good topic for discussion nonetheless.
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Dopeless Hopefiend

I've actually yet to see one study on post-Suboxone outcomes that comes close to representing how people really do their tapers on this forum.

Every study I have read has a fixed schedule, one-size-fits-all, you sign up you're on Sub for 3-5 months ONLY and you're following our routine. You have zero say in your own treatment schedule.

People then quote the outcomes of said studies as a rationale behind life-long-maintenance. Cmon??!

There are limits in the whole randomised double-blind study model, and this is one of them.

That's the exact quote i wanted to point out tearjerker, funny how great minds think alike!!!!!
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Stay sober friends,
Dopeless Hopefiend