Getting Off Suboxone

Anyone that knows anything about me knows that I'm a recovering addict and alcoholic. I've spent years struggling with the disease of addiction, and I've put some time together, only to relapse a few years down the line, for whatever reason. Mostly because I didn't do what I was supposed to do. For me, the formula is simple - stay away from the mood- and mind-altering substances and go to 12 Step meetings. Also, of course, I've required therapy. But the key to all of that, the thing that makes those things effective, is rigorous honesty. Getting honest is getting to the crux of the problem, and without that honesty, I, at least, am doomed to repeat the process.

There's a saying about "jails, institutions and death." I've been in enough institutions for five people. As far as jail goes, I've spent a night or two in the company of the County's finest, and it's not an experience I'd like to repeat. And then, of course, there's death, something I'd like to avoid for as long as possible, despite my bouts of depression that was so severe I felt like killing myself.

I've been on Suboxone for a little over a year, and my doctor has decided that it's time for me to come off of it and start living my life without replacement therapy. For those of you who don't know, Suboxone is a combination of buprenorphine, probably the strongest opioid in the world, and naloxone, also known as Narcan, which reverses the effects of opiates in your system. Suboxone is replacement therapy, similar to methadone, but with the key difference being you can just fill your prescription, take your medication, and go about your life, without having to go to the methadone clinic every day. It's been a lifesaver for me; I honestly believe that I would have been six feet under by now if I hadn't been prescribed this drug.

I won't get into the politics of Suboxone, and there is a lot of that. While there is a set protocol for getting people on the drug, there is no set protocol for getting people off of it. And many people are perfectly happy to stay on it for as long as their doctors, and their insurance companies, will allow. My doctor, however, has a set period of time during which he will treat his patients with Suboxone, after which you can either titrate off the drug or find another doctor.

Initially, I wanted to find another doctor, because I was terrified of not having the drug. Part of it was the blocking action of the naloxone; it kept me from doing any other opiates, gave me time to think in between that initial thought of, "I think I'll go get high," and being able to feel the drugs. It takes at least three days for the naloxone to leave your system, which is ample time to think about the consequences involved in the get-high. Part of it, however, was also the buprenorphine. I didn't want to face life with absolutely no buffer between my raw nerve endings and the rest of the world, and the bupe was that buffer.

On further contemplation, however, I decided that it was time to live life on life's terms, so I agreed to the titration. I started out on 16 mg. per day, and have gradually lowered my dose by 2 mg. per month.

Until this month. This month, he dropped me from 8 mg. to 4 mg.

The first day, I was okay. I won't get into the whole science thing, because aside from anything else, I don't really understand it. I'm a writer, not a biologist. But your brain is awash in the buprenorphine at higher doses, so dropping by 2 mg. when you're taking 8 doesn't really affect you all that much. Once you get to the lower doses, however, it starts to be noticeable.

Today is the third day at 4 mg., and I am definitely feeling it. I have nowhere near the energy I usually have. My bowels are....enthusiastic, let's put it that way. I've got leg cramps, and my sleep is shitty. But I'm determined to do this. Why? Because at some point, we have to face life the way it's meant to be lived, and that means no buffers.

I've prepared myself, though. I have a box that I call my "care kit." It's filled with such things as loperamide (Imodium) for the stomach issues, kava root for the anxiety, and B-vitamins for my nerves. I'm going to a meeting a day. I'm reaching out to people. I'm asking for help.

I'm not here to tell anyone what they should do in terms of their personal medical decisions. I've come off Suboxone before, and it was hell. I "jumped" at too high of a dose, and I was so miserable that I wound up relapsing. What I am here to tell you is that, if you choose to do it, it can be done. The last time I jumped, it was at 2 mg.. It was too high of a dose. I was thrown into withdrawals about two days in, and after two weeks or so, I wound up using, from the sheer misery I felt. This time, I brought two advocates into my last appointment with the doctor (the same one who had me jump at 2 mg. the last time) and we came to the decision to have me cut my 2 mg. strips in half for the last two weeks of the titration. Granted, I would rather jump at 0.5 mg., but 1 mg. is still far better than 2. I feel like shit right now, and I probably will feel like shit for weeks to come, but I know it will pass.

The key, I believe, is surrounding yourself with as many positive people as possible. If you don't care for AA or NA meetings, make sure you have people in your life who are supportive of your efforts to live life drug free. Do your research, and stockpile your supply of healthy foods. If ice cream is your thing, then fuck your weight and get some ice cream. Take care of yourself. Be kind to yourself.

You've come this far; there's no reason you can't go even further. If it is your choice to come off the Suboxone, look for positive stories of people who have done that successfully. There is a plethora of negative stories on the internet about people who have tried and failed, but if you dig deeper, you will find success stories. Read them. Because those are the people who have a message you need to read and absorb.

I can't predict the future, and I don't know how I'll do. I'm hoping that, with the supports I have in place and the positive people that I have in my life, I will eventually get off this drug, and live my life without the intermediary of pharmaceuticals. I'm still on my antidepressants, and I have no plans to stop taking them - they keep me from that suicidal feeling that landed me in the hospital for six weeks the last time. But they're not mood- or mind-altering, and they pretty much allow me to live my life without blinders. I'll report back on how I'm feeling, if only to give hope to others that you can do this.