The Suboxone Addict You Never Knew Existed
Suboxone is the only drug I've ever been addicted to. Seven years later, I'm still trying to wean myself off.
I don't think I'll ever forget the first few months I spent getting high on Suboxone. I was living in a small city at the time, and doing a decent enough job of supporting myself as a freelance writer and a guidebook author. I even had $20,000 in the bank - money I'd painstakingly saved over the previous two years, penny by penny, while I'd been working as an editor at an alt-weekly newspaper.
Life was pretty good. It wasn't terribly exciting. But it was good.
I had, however, been going through a bit of a dry spell at the time, relationship-wise. So when I met a woman who appeared to be not only smarter and more interesting, but also far more gorgeous than anyone else I'd ever dated, it was only natural, I suppose, that I began pursuing her with a laser focus, and with a level of intensity unlike anything - or anyone - I had ever pursued before. It wasn't long before we became an item.
I had been dating Kate, as I'll call her (not her real name), for maybe a month when she admitted that she had a problem with pills. Thanks to a nasty car accident back in college that had nearly killed her, she'd been taking legally prescribed narcotic pain relievers for the better part of a decade. But for the past few months, she told me, she'd been abusing her Darvocet prescription, chewing up a handful of the pills three or four times a day to get high. She wanted to tackle the problem right away, before it became a monster she couldn't deal with.
Kate learned about Suboxone while researching addiction online. It was a maintenance treatment, she said; a simple sublingual tablet that was being used to treat narcotic addiction. Increasingly large numbers of heroin addicts had apparently begun using it to kick their habits, and with a fair amount of success.
Finding a doctor who prescribed Suboxone was a bit of a hassle, and oddly, all of them insisted on being paid in cash for the service. But a week or two later, Kate had her induction appointment, and the next time I saw her, she had replaced her oblong pink Darvocets for a bottle of neon orange Suboxone tablets. It certainly seemed like a good trade.
* * *
It's probably worth pointing out that at the time, the world of narcotics and addiction was definitely not something I was familiar with. I had never once tried heroin. In fact, with the single exception of a Percocet given to me by a friend years earlier, I'd never ingested narcotics of any sort. Ever.
Sure, I'd had a cigarette habit in college. And I had certainly experimented with the middle-class suburban trifecta of marijuana, LSD and ecstasy. But I'd never been an addict. Drugs just didn't play much of a role in my life. And I suppose that's exactly why Kate pointed out one day - almost as a joke, really - that as someone with absolutely no tolerance for narcotics, even a tiny sliver of the Suboxone tablets she was now taking daily would probably get me extremely high. And boy was she right.
I suppose I tried it out of curiosity more than anything else. I was, after all, somewhat familiar with the basic facts of Suboxone - or buprenorphine, the drug's medical name. Opioid addicts couldn't get high off the tablets, for instance, assuming they used them properly. But after just five or 10 minutes of placing only a milligram or two under my tongue and then waiting for it to dissolve, I was totally transformed.
For starters, my social inhibitions disappeared completely, which is a pretty incredible effect for someone who is socially anxious by nature, as I've always been. After an hour or so had passed, I realized I'd been holding a largely one-sided conversation with Kate about nothing much in particular. But it was the physical sensation - a warming sense of overall calm and confidence - that really grabbed me. It was the first time I'd ever tried buprenorphine, and already I couldn't get enough.
In fact, I'm told the effect of buprenorphine on someone who, like me, had never been a user of narcotics, is not entirely unlike the effect of heroin: The entire body is enveloped in a sort of blissful, tingling warmth - a sensation that an old friend of mine who had once used heroin regularly described as "a full-body orgasm." To me, that sounded like a pretty accurate description of the physical effects I was soon beginning to experience more and more from Suboxone, which I'd begun sheepishly asking Kate for almost every time we got together.
It didn't take very long, though, for me to discover that two milligrams of Kate's Suboxone were no longer doing the trick, and that I would need to up my dose considerably if I wanted to really enjoy myself. When I close my eyes and think about that time now, the single memory that seems to pop up over and over again is an evening I spent alone in my apartment, rubbing the carpet fibers in my living room for maybe an hour or two with a drunken grin plastered on my face, and then blissfully organizing and rearranging the contents of my Ikea bookshelf until the physical effects of the buprenorphine eventually faded away. I have literally no memory of what I did with myself after the high disappeared.
* * *
Kate is one of those kind and empathetic souls who finds it hard to say "no" to anyone, but I could tell she was becoming more and more annoyed by my ever-increasing requests to bum one of her Subs.
Years later, she admitted that because she'd been sharing so many of her tablets with me, she'd actually had to cut back on her own prescribed dose. But I didn't know that at the time. So when she suggested that I should consider going to a Suboxone doctor myself - she figured I could make up a story about being an opioid addict in order to get my own prescription - I thought she was nuts. I didn't have the slightest inkling that I had managed to get myself hooked on Suboxone. Kate, however, had been around addicts for much of her life (her brother was, and still is, a full-blown heroin addict), and I guess she could tell.
Eventually, I did arrive at the realization that I had a bit of problem. I figured it out at the end of a long week during which, for reasons I can't recall, I hadn't taken any Suboxone whatsoever. For two or three days, I'd been experiencing something I can really only describe as a crushing sadness, which was odd, because there was nothing whatsoever for me to be sad about, and depression was never an issue I'd struggled with. That same week, an incredible pain materialized in my lower back - I assumed it was from slouching in a bad chair - but no amount of Ibuprofen seemed to make even the slightest difference.
When I finally broke down and told Kate was what was going on - and when I mentioned that I hadn't taken Suboxone in a week - she diagnosed me right away. "You're in withdrawal!" she said, fishing half of an eight milligram pill out of her purse and handing it to me. Ten minutes later, both the physical pain and the psychological pain had totally disappeared, as if by pure magic. The relief was so intense that I started laughing, and then crying.
A week or two later, I buckled and made my very first induction appointment with a Suboxone doctor. When he asked about my drug of choice, I told him I'd been abusing Oxycontin for years, despite the fact that I'd never so much as seen or even held an Oxy pill.
There were maybe 10 of us at the induction appointment, most of them young men in their twenties, stealing awkward glances at each other around a conference table in a tiny, florescent-lit room. As the appointment came to an end, we were each given a single eight milligram Suboxone tablet, which we placed underneath our tongues before getting out of our chairs and silently leaving the room en masse.
I wasn't used to taking eight milligrams of buprenorphine all at once, and I can still remember being so high as I drove home that for a moment, I considered pulling off the road and into a parking lot, and waiting for the effect of the drug to taper off.
* * *
That appointment took place about seven years ago, and I've gone through maybe a half-dozen different Suboxone doctors in the years since. I've given all of them the same bullshit story: I'm addicted to Oxys, and I'm using buprenorphine as a maintenance treatment. I've never told any of them the truth: that Suboxone is the drug I'm actually addicted to, and one that I've been trying to quit for ages.
It probably goes without saying that I don't get high on Suboxone in the same way I used to. It's certainly a hell of a lot harder, given that I now take it daily. But the truth is that I do still use the Subs to get high, despite the fact that I've tried to wean myself off them dozens of times, literally. As anyone who's been on buprenorphine maintenance for years is certainly well aware, the doctor visits and the medication itself are both prohibitively expensive. And that's to say nothing of the fact that I absolutely hate the idea of being enslaved to a medication that I don't even need, and that I never needed in the first place.
The weaning process always starts out so well. I lower my daily dose by two milligrams, and then by another two milligrams after a week. As the days pass, I find myself feeling more clearheaded; sometimes my energy level even increases. But inevitably, after going days without the slightly relaxed and slowed-down feeling Suboxone still gives me, the thought occurs that if I wanted to, I could probably get very high, given my newly-lowered daily dose.
And so to reward myself for a hard day of work, or maybe to prepare myself for a social event that might be causing me some anxiety, I take an extra half of a pill, or maybe I pop the whole thing. And while the sensation isn't anywhere near as pleasant as it once was, it does the trick nonetheless. And although I always swear I won't, I usually end up taking another monster dose the following day, and again the day after that, and before I know it I'm right back where I started, and needing to take my regular dose in order to stave off withdrawal.
Seven years on, I've almost reached the point where I'm ready to ask my current Suboxone doctor for help. The reason I've never done so before is because frankly, I'm terrified they'll cut me off if they learn the truth. What on earth is a doctor supposed to say to a patient who not only admits to abusing their addiction treatment meds, but whose entire addiction history is a lie?
And yet even if I were to finally tell the truth, and even if my doctor did claim to understand, what sort of help could they realistically offer? I've done my research, and aside from a treatment facility (which I can't afford) and ibogaine therapy (which seems dangerous and terrifying), I'm not sure any easy or obvious answers exist. The process of weaning yourself off Suboxone is just that: weaning yourself off. It requires a ton of discipline and willpower, and where buprenorphine is concerned, I seem to be seriously lacking in both.
So I keep doing what I've always done. I visit the clinic once a month. I get my prescription filled. I take my daily doses, and I try my best to cut back by a milligram or two here and there. But when the weekend comes, or when I'm having a bad day and I need an excuse to relax, I open the dresser drawer where all my meds are stored, and I reach for the buprenorphine bottle and the pill splitter. Then I sit down on my bed, and I carefully place the metallic-tasting pill underneath my tongue, and I wait for it to dissolve.
Daniel Mulligan is the pseudonym of a writer in Philadelphia. This is his first essay for The Fix.