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Trapped on Suboxone

Suboxone, touted as a miracle drug to help ease addiction to heroin, does not need to become your next addiction

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By Jennifer Matesa

12/02/13

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You got a problem with Vikes, Oxys or heroin? Go ahead, find a doctor to script you Suboxone. Or look on Craigslist for somebody selling their surplus.

But watch out, you might never get off.

The recent New York Times investigation into the “miracle-drug” that’s “saving” addicts finally began to expose something that many of us who have taken Suboxone have known for years: its manufacturer, Reckitt Benckiser, has employed aggressive tactics to find physicians interested in making loads of cash by turning the growing pool of painkiller addicts into Suboxone Lifers. And Reckitt also tries like hell to manipulate the FDA approval process, just so they can hoard the painkiller-addict market for themselves.

Reckitt can get away with convincing doctors that addicts need to be maintained on Suboxone because—as the Times story notes—common belief holds that painkiller addicts can never be drug-free. We’re told we’ve permanently screwed up our neurology. Popular thinking goes: Once you junkies take drugs, you might as well stay on drugs for life.

Today I’d rather have a good orgasm with someone I care about than all the Oxy or Sub in my local Rite Aid.

To support this belief, Reckitt and its growing army of reps offer twisted interpretations of research studies and anecdotal evidence about addiction and Suboxone. They claim studies “prove” that replacing painkillers with buprenorphine (the opioid drug in Suboxone) helps us stay “clean.” Ditch the old drug for the new drug and we stop shooting, snorting, stealing, doctor-shopping, tricking.

Same logic pharma used in the late 1800s when heroin was promoted as a “safe” replacement for alcohol and morphine.

Don’t get me wrong: I’m not saying drugs are inherently bad, and buprenorphine has a place in the ever-expanding American drug arsenal. That place is primarily as a detox tool—the purpose for which the FDA originally approved the drug in 2002. Suboxone saved my life when I used it this way. In 2008 a family physician licensed to prescribe Suboxone managed my detox from the fentanyl I’d been given for more than three years for migraine and fibromyalgia, despite studies showing opioid painkillers aren’t the best treatment for these disorders. Given my genetic history and psychological profile—which were not documented as part of my medical history: in other words, the pain specialists didn’t screen me properly for risk of addiction—repeated exposure to these drugs flipped the addiction ON-switch. By the end I was changing dates on scripts (a felony each time) and being picked up for petty crimes like compulsive shoplifting.

After watching my 68-year-old father die of cirrhosis and cancer, my desperation to live drug-free increased even as my addiction flushed me further down the sewer. I knew that if I were going to try to detox, I’d have to hire yet another doctor; my pain specialist was awesome at getting me on drugs, but she hadn’t the first clue how to get me off.

If my “Sub doc” had believed—as so many doctors do—that somebody like me could never be drug-free, I’d without a doubt still be on drugs today. Hell, which of us inside active addiction believes we can do without drugs? I’d also be experiencing nasty side-effects for which people who read my addiction-and-recovery blog write in asking for help. Long-term Suboxone “therapy” can shut down the endocrine system and cause thyroid dysfunction, low testosterone, and premature menopause, leading to a cascade of other health problems including infertility and osteoporosis.

Oh yeah, and say sayonara to sex! I feel for the folks who tell me they can no longer get it on or get it up. I was on Suboxone for just two months and it killed off my sex-drive the way all the other opioid drugs did. And quite frankly that’s saying a lot, because I have a strong sex-drive. But in order to feel that part of my life, I have to be off drugs. Today I’d rather have a good orgasm with someone I care about than all the Oxy or Sub in my local Rite Aid. I cannot have that connection while I’m on drugs.

Read the comments section of the Times story and you’ll see people believe you can’t use Suboxone to get high. This is bullshit: you can. I have in my files emails from people who are in prison and abusing Suboxone; people who started using Suboxone while in rehab and discovered they could get sky-high; suburban American college kids who chip Suboxone because it numbs out their self-doubt; ordinary folks who have asked their doctors for help with a 50 or 60 mg Vicodin or Percocet habit and were kicked into Suboxone programs, where their little baby drug-habits and relatively unscathed nervous systems were bombed out with 16 to 24 mg of Suboxone—the equivalent, in binding power (not analgesic power), to upwards of 800 mg of morphine. These are the stories that piss me off, and they are not being represented in the press.

It’s damn hard to get off Suboxone. It dissolves in body-fat and sticks to the body’s painkiller receptors like Liquid Nails. For many people it’s hell to scrape off without professional management and a social support system. After quitting, it can take months for the drug and its metabolites to leave the body. I’ve spoken to heroin addicts who would feel better within two weeks of kicking smack who, after doing time on Suboxone, have never felt normal again. I know some doctors who, based upon vast anecdotal evidence, think this drug—an opioid partial-agonist, a substance that does not occur in nature—does special kinds of harm to the body that researchers haven’t yet discovered.

Just like doctors who can’t detox their patients off painkillers, most doctors who prescribe Suboxone don’t know how to help their patients quit. So the patients wind up asking me to be their doctor. One woman recently begged me to manage her detox in exchange for payment. I declined, but I was left shocked at the desperation of some folks out there to live a drug-free life, so much so that they will contact a total stranger and offer cash for an amateur detox. This speaks to the sorry state of treatment (not to mention the general health-care system) in this country.

These folks read my blog, they know I got off drugs including Suboxone, and they can see I’m living a productive drug-free life. I write them back, but I can’t be their doctor. The best I can do is keep writing stories like these, and letting policymakers, researchers, and practitioners know that they need to open their minds about how well most addicts can live, how much we can heal.

Jennifer Matesa is a Voice Award Fellow at the federal Substance Abuse and Mental Health Services Administration and is the author of the blog Guinevere Gets Sober. Her forthcoming nonfiction book about physical and spiritual fitness for living clean and sober is due out Fall 2014.

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