The Great Suboxone Debate - Page 3

By Jennifer Matesa 04/13/11

When it was first released in 2002, Suboxone was hailed as a major advance over methadone. But millions of scrips later, critics charge that the seductive opiate "cure" is causing its own epidemic of addiction. 

Bupe: detox breakthrough, but what about maintenance therapy? Photo via

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Despite radically opposing views, what’s clear is that each of these physicians is operating out of his own conviction that people with addiction need better treatment than they’re getting.

Darlene Bryson, for one, simply doesn’t know what to do. She feels caught between her desire to escape the rat-race of addiction and her fear of slavery to cravings. She quit Vicodin cold turkey, but then had a pain flare-up that sent her back to the doctor for Norco, a lower-dose version of Vicodin. She has disciplined herself to stay within the dose of four to six tablets per day, but it’s a struggle. And the Suboxone program would require her to take an entire week off from work for in-office administration of the drug. Shunned by several physicians because of her addiction, yet in need of pain treatment, she hasn’t yet found anyone who can—or will—treat both problems.

“I’m having a hard time not being on [Vicodin],” she says. “I thought I was doing the right thing by telling the truth. Now I just wish I’d never said anything, and suffered in silence.

Suffering in silence is an unsatisfactory and unfortunate answer. It sucks, frankly. I've done it myself. But until better ways of treating pain are found—and the social stigma of addiction reduced—it’s an answer many patients will opt for, either off drugs or on. So bupe detox or maintenance, for now, remains a difficult personal decision.

It was a decision I muddled through. In 2008, while continuing to take large doses of fentanyl, I found my way into the care of a knowledgeable and compassionate outpatient detox doctor who uses bupe. I had no idea what I was doing or where I was headed—all I knew was this: I’d become a slave to the drugs that had once helped me cope with intractable pain, and I couldn’t bust the chains on my own.

After a difficult induction onto Suboxone, I felt better than well. I woke on my third morning in detox to a crystalline Labor Day Weekend. Standing at the back dining room window I marveled that the sun was actually shining on my skin, that the garden smelled gorgeous. “The world is beautiful,” I said.

“You haven’t said that in years,” my husband said.

I quickly tapered from 14 mg to about 6. Many other things returned that had been diminished for years: my senses of taste and smell; strong appetites—for food, sex, work, humor, life. Music sounded somehow psychedelically brilliant, and I sang in a clear voice. I laughed, a rich full laugh that I recognized from, it seemed, another life. And I slept well.

So of course I asked my doctor if I could stay on Suboxone forever. He had no more maintenance slots left. And then, two or three weeks in, still at 6 mg—I was dragging the taper out as long as I could, because I Felt So Well—the affair went sour. My appetites gradually diminished. My voice clogged up again. My attention was constantly dragged back to how I was feeling—and whether it was time for my next dose.

It took me six more weeks to get off Suboxone, and it was during that time I started going to meetings. I probably could have tapered more quickly, but what slowed my descent onto the tarmac was simple: I was afraid of having nothing left to take. I had taken painkillers every morning, to cope, for so many years. Now, fortunately, I don’t have to.

Jennifer Matesa writes about addiction and recovery issues on her blog, Guinevere Gets Sober. She is the author of two nonfiction books about health issues, including the award-winning journal of her pregnancy, Navel-Gazing: The Days and Nights of a Mother in the Making.  

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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. She is the author of several books, including the non-fiction, The Recovering Body, about physical and spiritual fitness for living clean and sober. You can find Jennifer on Linkedin or follow her on Twitter.