Should Suboxone maintenance be your solution for drug or opiate addiction? Should you seek out MAT, or medication assisted treatment, in order to give yourself a better chance at getting off of opiate based drugs?
It’s a fair question. A few decades ago the world was introduced to methadone, and the idea was hard reduction–if you could switch heroin users to a safer alternative, that was better than dirty needles and death by overdose, right? That was how the thinking went, and it certainly helped some people, while probably perpetuating addiction in others. It is difficult to know for sure, but anyone who has tried to detoxify their body from methadone can tell you that the “cure” in this case might be even worse than the disease, as the withdrawal symptoms can be just as intense as heroin withdrawal, and in some ways even worse.
So where does that leave a solution like Suboxone therapy? Well, suboxone is the newer drug on the market that is far less….euphoric…when compared to methadone. In technical terms, methadone is what is known as a “full opiate”–if you take enough of the drug, it will eventually make you coma and die. Suboxone is only a “partial opiate” in that it will stop flooding the brain after it fills up all of the opiate receptors.
The reason that Suboxone still has street value is because a typical opiate addict is in a constant cycle of withdrawal, followed by scoring some form of opiate to avoid being sick, followed by more withdrawal symptoms. Once you get caught in this cycle for long enough you begin to feel as if just “getting well” from the threat of becoming dope sick is about the same thing as getting high, or experiencing euphoria.
So what you have to realize is that the opiates–whether that was heroin or prescription pills–stopped being fun a long time ago for most addicts. And instead of getting high and feeling groovy, they are often just seeking to get well.
Now when you first try to get clean you are going to go through an uncomfortable detoxification period, and no one likes to do that. That is why addiction exists–the opiate addict seeks to avoid the discomfort of withdrawal. But while acute withdrawal only lasts about a week or so, it is possible to experience “paws,” or post acute withdrawal syndrome, for several months or even years after you stop putting opiates into your body. Depending on how heavily you abused opiates and for how long, your withdrawal symptoms can be very, very persistent.
So for some people, taking MAT such as Suboxone makes a lot of sense. Such people may also suffer from chronic pain issues, which may be why they got addicted to opiates in the first place. So this is definitely something that you will want to discuss at length with your doctor, and you may also want to get more than one doctor’s opinion when it comes to such topics, because it is a very specialized area of medicine. There are many, many physicians out there who do not really have any experience at all in dealing with Suboxone, nor do they have a lot of education when it comes to the topic of pain management in someone who suffers from drug addiction.
For example, it may be helpful for you to understand exactly how opiates actually treat pain in the human body.
Your brain gets pain signals from the part of the body that is experiencing pain, and you can imagine these pain signals as being similar to an old fashioned alarm clock with a hammer hitting a bell. When you take opiates in order to try to treat the pain, what you are really doing is sticking a rag in the alarm clock in order to dull the pain signal. In reality, you are not reducing the pain at all when you take opiates, all you are doing is causing your brain to care less about the pain signals.
Contrast this with a medication such as Ibuprofen, an NSAID, that actually reduces inflammation in the body and thus physically makes the pain become less.
Now if you ask any addict, they are obviously going to prefer the opiate, because that is a solution that can scale much better than an NSAID like Motrin. In other words, you can only take so much of an NSAID in order to reduce the pain, and then it reaches its limit. But with an opiate, you can just keep taking more and more of the drug until your brain goes into a coma state and you experience total and complete oblivion. In other words, while the NSAID may be better at actually reducing pain, the opiate can block reality out entirely–much more thoroughly than an NSAID can, and therefore it has addictive potential.
You may or may not need MAT in order to remain clean. I would suggest that if you are not experienced in addiction treatment yet that you might try traditional inpatient treatment before you jump head first on the MAT bus. In other words, give traditional treatment a chance–go to detox, go through rehab, and see how you do. Don’t borrow trouble from the future if it hasn’t happened yet. You may do much better than you expected in terms of dealing with early recovery, overcoming cravings, and so on.
That said, if you have been banging your head against the wall for a long time and you are struggling to find any kind of recovery in your life, you may consider making a move–go to longer term treatment, talk to your doctor about MAT options, and consider making a more serious commitment to your recovery program this time around. Often the only difference between success and failure in recovery is based on the level of surrender that you achieve. If you want to do well in early recovery then you have to dedicate your entire life to recovery, period. If you hold back and try to maintain some control over things for yourself then you are likely to be disappointed.
That said, you might talk with both your doctor as well as your substance abuse therapist in order to determine just how helpful Suboxone might be for you. Between all of those expert opinions you should be able to find the optimal strategy moving forward. Just keep in mind that you need to actually seek out a substance abuse therapist, as well as a doctor, in order to get the best possible guidance for your early recovery.
Above all, consider starting this process at an inpatient treatment center. This is almost always going to be the best possible choice for you to get started on success in recovery.