Saturday, August 14, 2010

More Suboxone Problems

A few days ago we started another person at The Coleman Institute for a Suboxone Detox, one of our Accelerated Opiate Detox programs.

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Like many people who come to us for help, Steve (not his real name) was put on suboxone to get him off high doses of percocet and oxycontin for a previous sports injury and surgery.

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At the time, about three years ago, it seemed like a life saver; he was able to take a long acting opiate blocker and function. He wasn’t constantly watching the clock, wasn’t constantly worried about the next dose, and could even get a refill. His doctor was full of concern and confidence.

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Although it was pricey, because his doctor only worked on a cash basis, that was ok because he was off his pain meds and his pain was more than manageable using over the counter ibuprofen and such.

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The problem came when he wanted to stop the Suboxone.

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His doctor told him to drop back from 32mg a day to 16mg. No problem. It was a little tougher to go from 16mg to 8mg, but the real problem came when Steven tried to drop below 8mg/day.

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He developed severe withdrawal symptoms.

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Steve is a lawyer. He was unable to do his work while experiencing the withdrawal. His doctor suggested a medication in the benzodiazepene family: xanax. This really worried Steve because he learned how addictive this class of meds is as well. He really didn’t want to get on a drug to get off another drug.

Suboxone has an incredibly long half-life, meaning it stays in your system for a long time, and it has a very strong capacity to bind to opiate receptors. This is why it can be an excellent choice for people who choose maintenance therapy to get off opiates, but not so great for people who choose abstinence. This is also why it is so hard to detox on your own.

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Steve is doing great. He is on his 4th day, and in a few more days we will have the majority of the suboxone flushed out of his system.

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We have a good time with our patients. We like our work. This isn’t an easy thing for them to do, and we are really good at it. Give us a call if we can help.

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Joan R. Shepherd, NP

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