After years of heroin abuse, I’m clean. With no desire to use, no cravings, and no fear of relapse, I’m a healthy, functioning member of society for the first time in a decade. I’m able to be happy, not just because I’m treating my addiction with Suboxone, but because I was able to take a time out, treat myself, and change my life.
Suboxone, a brand name of Buprenorphine, is a controversial drug. When I was first approached with the concept of taking it, I was resistant. How can I be clean if I’m taking another drug? The internet was filled with articles like “Suboxone is not sober”. Some recovery groups don’t even accept people in MAT (Medication-assisted treatment). I’d also had long periods of addiction to prescription opiates. Was Suboxone just another one of them? I didn’t want to stay addicted.
But, I’d tried getting clean in the past. I’d managed days of agonizing withdrawal, but I’d always relapsed. My longest recovery period was almost 3 months. I’d attended a detox, gotten treatment, and then relapsed when I stopped attending counseling, when I’d started embroiling myself in the same stress as before. Now, I wanted to do it differently.
My Journey to Medication Assisted Treatment
The treatment center I’d chosen offered a MAT program, but they also offered a lot of information about it. I consulted with my doctor. Buprenorphine is an opioid similar to the heroin I’d been taking. However, it also wouldn’t get me high. I’d also be pairing it with a drug called Naloxone so that I couldn’t abuse it. My doctors talked to be about the risks. I’d still become dependent. When I did make the move to get off Suboxone, I would have to go through withdrawal, but without cravings and with full medical support. There were pros and cons, and I was able to discuss all of them to determine what they meant for me.
I also learned that behavioral-only interventions, like I’d done in the past, don’t work for everyone. In fact, about 80% of persons receiving behavioral-only treatment relapse when they stop seeking treatment. I’d experienced this for myself. Buprenorphine treatment has also been shown to increase the likelihood of remaining abstinent well above standard programs. It reduces instances of opioid overdose, exposure to transmitted diseases, and is shown to be more effective than treatments not using opioid replacement therapy.
Buprenorphine is also recommended by organizations like SAMHSA, World Health Organization, the CDC, and NIDA. These organizations list access to buprenorphine as a basic human health right, alongside medications such as antimalarials. Yet, less than 50% of all rehabilitation centers offer medication-assisted treatment thanks to stigma and low rates of adoption.
Most importantly, while many of the fears surrounding Suboxone relate to previous issues with persons abusing buprenorphine, that’s difficult to do with Suboxone. Suboxone mixes buprenorphine, a partial opioid agonist to prevent cravings and stabilize the body, with Naloxone, an opioid agonist that prevents users from getting high. If I or any other user were to crush it and inject it to get high, we would immediately go into withdrawal. This safety net was important for me, because I didn’t want to be able to abuse the drug I was taking to treat my disorder.
Taking Suboxone to Fight Heroin
I started my medication-assisted treatment with Suboxone when my withdrawal symptoms started. An 8mg dose of buprenorphine combined with 2mg of naloxone taken in strip form. Taking that first strip was nerve wracking. Would it work? Would I stay addicted? Would I wake up in a year to find myself as hooked on Suboxone as I was on heroin now? Apprehension quickly turned into relief as my withdrawal symptoms abated. I’d weathered the worst of heroin withdrawal before and the shaking and sweats had already started. I’d been dreading it.
I also wasn’t high, I wasn’t experiencing cravings, and I wasn’t focusing my energy and attention on getting more heroin. I was clear-headed, I was happy, I was me. Taking my daily dose of Suboxone, I started attending treatment again. Of course, it wasn't an instant cure. I stopped taking Suboxone after the first two weeks and binged on heroin. When I started my dose up again, I felt terrible, but I was more determined than ever to continue my MAT program.
This time, I learned from it. Free from cravings and the constant itch under my skin, I was able to work with my counselor and my therapist. I went to cognitive behavioral therapy and then SCHEMA, and attended counseling sessions.
Leaving recovery, I went home. I had no desire to use. I walked by some of my old buddies and didn’t feel a thing. No cravings, no sudden rush of need to use, and I didn’t relapse. I began attending weekly 12 Step recovery meetings. I focused on my life, my career, and I started dating again.
With the caveat of the fact that I fill a prescription, take a morning dose of Suboxone, and still attend meetings, I was more normal than I’d ever been.
Moving on From Suboxone
After just over a year of Suboxone treatment, my doctor decided it was time to try living without treatment. We agreed on a tapering program, where I slowly reduced my dosage, cutting the dose by half every 2 weeks. Then, the final dose. I braced for a horrible withdrawal, cravings, everything I’d experienced before when withdrawing from heroin. Instead, I felt like I had the flu. I couldn’t sleep. I sweated buckets. I felt uneasy and my anxiety spiked. But the pain and stomach cramping and life-altering anxiety and paranoia I’d experienced getting of heroin never came. My symptoms went away after a few days and I was free.
I was also nervous. What if I’d relapse as soon as I no longer had Suboxone to help? I kept going to meetings, I scheduled several follow-up appointments with my doctor and waited for the cravings to come back. They didn’t. I started to realize that maybe people were right, Suboxone is a crutch, it helped me stand up until I learned how to do so on my own, with support from my aftercare program and my clean and sober friends.
I’m still clean. I’m off heroin for the first time in my life and Suboxone helped me get there. It wasn’t easy. Suboxone didn’t take away the need for me to put in the work. I got off of Heroin myself and Suboxone provided the support I needed to do so until I was ready to stand on my own.