Pain Pill Addiction Blog

Hello! I am a physician, board-certified in Internal Medicine and Addiction Medicine. This blog was created to help people better understand the medication-assisted treatment of opioid addiction using either buprenorphine (Suboxone) or methadone. I will be writing about different aspects of this topic, as well as the treatment of addiction in general. Hopefully, I will get a few questions, too.

185 responses to this post.

  1. Dear Jana,

    I have just found your blog through onepillawayfromchaos. I have been looking for something like this for 3 years! I have not yet had the chance to read through all your posts but once I have, I will be sure to come back with many questions.

    My sister is a heroin addict. In and out of recovery. I have never understood her relationship with methadone. She has a history of buying it illegally, something I could never understand as she is legitimately entitled to it. I guess she was taking it to compliment her addiction to heroin. She lives in London and I live in Switzerland where they actually have a nationally approved heroin programme…

    I have been blogging about my sister since February when she relapsed under our roof. It has helped alot because I have gained insight from families and addicts alike. I look forward to reading your blog and gaining more knowledge on a subject I need to know more about.

    Many thanks
    Nora

    Reply

    • HI Nora, I’m from the united states and was addicted to oxycontin for several years. And I’m goint to be honest up front. Suboxone saved my life period, I don’t even crave an opiate, I can hold them in my hand and hand them back, IT WORKS without it I’d be dead by now or in prison. I applaud your actions to get her help. SO many people where I live don’t understand the addiction, they think you can just stop if you put your mind to it, and we know that isn’t the case. I’ve been on suboxone for a year and I have never felt better. If there is any way you can get her on the suboxone instead of methadone you WILL see a big difference. If you need to talk to someone outside your family please feel free to email me. (roylane48@hotmail.com) I’ll be glad to talk to you or her. Good luck to all of you and don’t give up. I’M WALKING PROOF IT WORKS.

      Roy Lane

      Reply

      • Posted by Sixela on February 6, 2012 at 7:03 pm

        Hello Nora. I’m a young woman.. almost twenty years old. I have had doctors prescribing to me for over a year for chronic pain disorders..ranging from my back (and surgeries) to my knee (multiple surgeries) and foot.. Those are my main problems with pain. I’ve gotten so much better and grew from what I once was.. when I was strongly addicted at one point. I straightened myself out. I am straightening myself out completely again. I hope to get some encouragement and inspiration from others who have felt the pain, desperation, embarrassment,.. It’s nice to know that I’m not alone. I just feel so upset that so many health problems have impacted my life so greatly in a variety of ways. From being misdiagnosed for a year and losing 75 pounds- coming so close to death..to now..getting healthy and my life back on track. I hope to find a friend that I can confide in that knows how it all feels….

        The last thing I want is sympathy. I just search for understanding- no more negativity. Only positiveness and getting better/healthier! :)

        Take care all.

      • Posted by Eric VT on September 1, 2012 at 9:17 pm

        Roy as a addict you should know It does not matter what kind of sub she goes on on. The bottom line is if she or any addict does not want to stop using they won’t. Methadone was actually the only opiate substitue that worked for me in the end and saved my life. I have been on the clinic now for almost 11 years. But it did not start working for me in being able to live a normal productive life until I actually wanted to get clean and stop using not just opiates but all drugs. The bottom line I just was not ready to stop and still wanted to be a weekend warrior. It was not until I wanted to get clean that it worked.

  2. Hello Dr. Burson,
    I have found your blog doing some research for articles to post on a methadone forum I run. I wanted to tell you how much I appreciate your blog and your open mindedness where addiction and opiate replacement therapy are concerned. I have been a methadone pt for over 11 yrs now. I tried traditional rehab 3 times and would fail each time. I suffered from depression for as long as I can remember, even as a child of 8 or 9 yrs old. I won’t go into the long story, but sexual abuse, mental abuse and physical abuse were frequent in my life as well which I think exacerbated the depression. As a young teenager I was put on hydrocodone for severe endometriosis. I also had several surgeries for the female issues, which called for pain mgt. It wasn’t long though before I realized these pain killers not only killed my physical pain, but my emotional pain as well. Again, I won’t go into the long story but that began my addiction cycle with pain killers. It went on from the time I was 17 untilI was 29 yrs old. Again, I tried traditional treatment 3 or 4 times and would fail. I couldn’t even stop when I was finally able to get pregnant and stay pregnant with the miracle baby we thought we would never have and that I carried past the point of miscarrying. NOTHING could help me! I was hopeless and to the point where I wanted to die. I was on the verge of losing everything important to me! The only thing that had kept me out of jail all these years of stealing other ppl’s meds and forging scripts and such was teh fact that my husband was a well respected minister’s son and police officer in the town we lived in. I just wanted to die rather than keep hurting him and our son. That was until a doctor prescribed me methadone to treat my addiction. I knew from the first day or so that this treatment was going to give me some hope and a real chance at recovery. Of course, this doctor wasn’t certified to prescribe methadone for addiction so he was trying to wean me. I was fine all through the treatment but when I got to the last 10mg, I started to struggle again. I ended up at a methadone clinic instead and I have been on methadone ever since. I have tried several times to detox, but I would get down to about 35mg and would struggle again. I almost lost everything with my addiction before and I don’t want to EVER take that chance again. SO, if that means staying on methadone for the rest of my life, I am willing to do that rather than risk losing everything that is important to me because of addiction. Again, I am trying to make this short but all these years on ORT (opiate replacement therapy) I have had to deal with doctors and medical professionals who DO NOT agree with any form of ORT and certainly don’t support it. I have been denied pain medication coming out of an appendectomy, denied pain medication during LABOR and treated horribly by people who have preconceived ideas about a person on MMT. The majority of medical professionals that I have had experience with, DO NOT agree with ORT…..no matter if it’s with suboxone OR methadone.

    I say all that to say this, it is so refreshing to hear from a doctor who was actually able to recognize that the idea they had previously about methadone pts may not have been accurate or fair.

    I follow your blog religiously! I haven’t had the chance to read your book yet, but I have it on my wish list. Thank you so much for the blog, for sharing your information and ideas and for treating your addiction patients like human beings worthy of care just like anyone else.

    Reply

    • Thank you, thank you so much for your kind comments. It comes at the end of a particularly trying day, and means so much to me!

      Reply

      • Hi my name is Kate, and I am a recovering addict. I was in active addiction for seven years and finally got clean and have been for a year. Your right your sister will stop when she wants to stop and usually it takes rock bottom if not there are only institution prison or death. I do not take anything today to keep me sober but na meetings and a great support group. We drug addicts and alcoholics think and do things a lot differently and use to fill the void in our life that is missing. That is why when one gets clean it’s like we are babies, we have to learn to crawl then walk. We have to learn to sit through and feel every emotion no matter how uncomfortable instead of covering it with a high. I hope this helps and wish the best of luck to u and ur sister

  3. Posted by Jessalyn on March 31, 2011 at 4:16 am

    Is it true that if you go into treatment and accept suboxone as treatment that you can never again be prescribed pain medication even if needed. (for example, if you were in a car wreck or had a major surgery) Is this true even if you pay for treatment without using insurance?

    Reply

    • No, that’s not true. Things happen to all of us: broken bones, surgery, etc., that must be treated with pain medication. For a recovering addict, that’s a high risk situation, but precautions can be taken to get through such a time without relapse. Suboxone is usually not enough for acute, severe pain. There are options, but generally my patients stop the Suboxone to go on short-acting opioid medication until the situation is resolved. I try to get them to find a dependeable non-addict to hold their pill bottle, I see them more often, and of course if they’re able, go to extra 12-step meetings. Narcotics Anonymous even has a booklet, “In Times of Illness” which speaks more on this question.

      Chronic pain is a different matter. I prefer to try to find a non-opioid way to manage chronic pain, and perhaps the Suboxone helps enough to make the pain managable.

      NO ONE should be denied pain control because they have a history of addiction. It has to be dones more carefully, but it’s inhumane to withhold opioids for acute severe pain. Sometimes I have to call my patient’s surgeons, for example, to reassure them it’s OK to give opioids like they would for anyone else, and explain the precautions we can take with these high-risk patients. Usually I see them more frequently in the office, if that’s possible, and I encourage the other doctor to see them more frequently, and prescribe fewer pills at a time.

      Reply

      • Posted by Roy Lane on February 3, 2012 at 10:00 pm

        If you are injured you can still be prscribed pain medicine. Just let the Dr. know that you are taking suboxone. The pain medication will kill the pain you just don’t get “high” from it. At least thats what my suboxone Dr. tells me.

      • Hi Doctor

        Were you aware that NA also has a written policy that states that patients on methadone or suboxone are “in active addiction” and are not to speak/share at meetings, hold office, etc but rather are to sit in silent shame as having “used that day” and then told to “get with someone after the meeting” so they can be encouraged STRONGLY to get off medication assisted treatment? Many professionals in the field recommend NA for their Medication assisted treatment patients without being aware of their official policy on this, or that their patients will be strongly urged to reject the very treatment they are prescribing if they attend these groups and admit their MMT/Sub status.

      • NA also says “the only requirement for membership is a desire to stop using.” My patients have earned their seats. I tell them be careful who they tell they are on medication. The most important part is listening, anyway. Many addicts will welcome people on methadone and Suboxone with open arms, and some will not.
        And there’s always AA; some addicts feel more comfortable there, and use what they hear about alcohol to apply to drugs.

      • Many AA groups feel that having addicts as members dilutes their message of recovery (though I disagree strongly) and so members are discouraged from discussing anything but alcohol abuse.

        As for NA, yes it’s true that is the only requirement for membership–however–if you search for NA bulletin #29 you will be able to read their stance on methadone, and recently they updated with a newer bulletin, which basically says the same thing–that they strongly discourage members from using medication assisted treatment, that their official policy is still that this is active addiction and such patients should not speak or share, but that ultimately they recognize that individual groups can choose whether to allow this or not. They then go on to suggest that such members, rather than being given the right to share their recovery story or hold office, instead be encouraged to “sweep up and clean ashtrays” so they can feel part of the group that way instead.

        Many people have the argument that they will just refrain from saying anything about their medication. That’s all well and good if it suits you, but my feeling is, it is misleading. If I go in there and stand up and take keytags for my years of recovery and when they want to hear my speech, I just talk about meetings and steps and higher powers and whatnot and say that that is how I recovered, I am misleading people. There may be someone brand new in attendance–someone on methadone or suboxone–and when they hear me say my piece, they may think “Wow, she abused opiates for years and she got better with just the 12 steps, so I should be able to do that too!”, when in fact, my methadone treatment was and is vital to my recovery. By being forced to hide that fact in order to gain acceptance at the group, I am betraying my own self, I am keeping shamefully hidden the treatment that saved my life, and I am not being respectful of the written, official policies of the group I am attending, which asks that MMT patients not speak and “get with someone after the meeting”.

        Please don’t misunderstand–I think what you are doing is a wonderful thing. But so many practitioners are not really aware of these policies and how it may harm their patients. These are two different modalities and they are not necessarily complimentary. I teach classes for MMT patients and run a longstanding forum/board for them and I can tell you that this comes up over and over again, where people are either forced to go to 12 step groups or strongly compelled to go, by their MMT providers, and as a result, end up completely confused, feeling great guilt over their treatment, etc. It’s almost like a doctor prescribing medication for a physical illness and then insisting that the patient attend meetings of the Christian Scientists, who as I understand it, forbid the use of medication.

        I have been to many hundreds of both NA and AA meetings in my time, and while some are more accepting of medication than others, at each group, there was a strong undercurrent of feeling that taking medication to support one’s recovery is wrong, and is no different than giving a bottle of whiskey to an alcoholic, etc.

      • There are some AA groups who tell members not to talk about drugs. but as you probably know, at most meetings, no drug is mentioned anyway. It’s more about sharing experiences & feelings and how to get through problems without the need to get high.
        I have around 100 Suboxone patients in my office, and around 23 are avid 12-step recovery group members. Most of them have gravitated towards AA for some reason. I also have 2 in Alanon, and several in Celebrate Recovery, a Christian 12-step based program. For the patients who go and feel a connection there, it’s been a tremendous help.
        I don’t force my patients to go, if they don’t feel welcome. Groups in this area vary quite a bit about their outspokenness against methadone and Suboxone. I do insiste they get some form of counseling or therapy, and 12-step meetings are only one option. If a patient has limited ability to pay for private counseling, 12-step meetings are a great option. I’d also be OK with secular recovery meetings, but this area just doesn’t have any.
        I would love to have a Methadone Anonymous to refer folks to, or medication-assisted anonymous or whatever.

      • I also looked at your website – nice! Great participation. You are doing important work there. Patients in medication-assisted recovery, I don’t have to tell you, face so much ignorance, prejudice & bias…it’s great to have a site that’s supportive!

      • Thanks! There are actually several secular support groups out there, such as Secular Organizations for Sobriety (SOS), Lifering, S.M.A.R.T., Women for Sobriety, etc but they are in no way as prevalent as the twelve step groups. Methadone Anonymous groups often meet at clinics–they are patient-run and materials and readings are available online. Perhaps you might talk to some patients about starting one up. If you need help finding materials, let me know. Also, there is a website called methadonesupport.org that used to have and may still have online nightly methadone anonymous meetings.

        Thanks for your reply!

      • To the comment about na telling people that are on suboxene to not talk and sit silently inshame. This is not the case. Everyone who comes is free to speak about their experiences with getting through the rough times and the great experiences of making it. It’s like this: you don’t go to the doctor cured well same as with na and aa. When u do want help u may go to a meeting physically or mentally using. Yes there is a difference, we always relapse before we even take the first drink of drug, and believe me aa and na meeting have saved many lives and I am greatful for bill he taught me to accept and to take my life one day at a time, because I am worth it

      • It is true! Please don’t tell people otherwise because I will tell you right now from experience. I went into Suboxone treatment for opiate addiction. 6 months later (one year ago) I was in a terrible crash. I went to the emergency room. They did ex-rays and although my neck wasn’t broken,. it looked and felt really bad. They gave me toradal for pain and referred me to an orthopaedic dr. I had my chart in my hand as my boyfriend wheeled me to the check out desk, as I couldn’t walk for several weeks after the crash. I noticed my chart said, “history of narcotic use” which is info they only could have had by seeing my pharmacy profile. They used it against me and every doctor I’ve seen since has done the same. I see a Chiropractor, lol! All the discs in my neck are ruptured and half in my thorasic and lumbar spine. The tendons and muscles in my arms were ripped and had to heal on the own with no help from a physician because of my history. To this day, no doctor has helped me with my recovery and I’m still in phase one of recovery according to my Chiro. He can only help me so much, I guess,

      • Doctor, I just wrote you again, and have been trying to get much needed advice as I was and have consistantly been denied pain medicine after 2 major car accidents,

      • I’m sorry but I’m sure you’ll understand that I’m not able to give you advice, especially since your case is so complex. I can say that they patients I’ve seen successfully taper off methadone have done it slowly, over at least six months, even more. I would suggest you talk to the doctor at your OTP, voice your concerns, and formulate a plan with her about the best courst of action.
        Best wishes.

      • In the city I live in, once you have been to substance abuse treatment of any kind, you are black-balled, or at least I was. I tore muscles, tendons and ruptured many cervical discs, etc. I wasn’t able to walk for a few weeks after the accident. But because I was in a Suboxone treatment program, my medical record states, “history of narcotic use” so they gave me toradol and sent me home. No one has been even willing to treat me except for a Chiropractor. I’m applying for disability because I’ve been unable to work for over a year now.

      • That’s a shame. Having the disease of addiction does not mean you can never take pain medications. It does mean that you must be careful if you have to do so. Certainly long-term ( more than 3 months) would be problematic, but opioids for a few days after an acute injury is not unreasonable. Addicts, both in recovery and not in recovery, do feel pain with injuries and should be treated with opioids when appropriate. Judging There are ways to make it safer for you – find a dependable non-addict to hold your pill bottle, schedule more frequent follow up visits with your doctor, etc.

      • This is excellent information and counsel. My only additional comment is the role of loved ones… Loved ones can dramatically decrease the risk of a relapse following surgery if the become a part of the process. Some families may feel hesitant but it is the most effective and efficient way if done appropriately. I am reminded of a gentleman who returned to opiates following dental work. He continued to use in secret. A year later his wife found out about his full blown relapse… Sadly he chose to take his life rather than to start recovery again. I don’t share that story to scare you. I share it to encourage families to become a part of the recovery solution.

      • I agree. Involving the family is so important.

    • Posted by Jason on June 28, 2011 at 8:57 pm

      I have chronic pain from compressed discs and a titanium plate in my pelvis. I take suboxone 12mg per day and most of the time I still ahve pain. What medication can I take? I’ve tried naproxen but it didn’t help.

      Reply

      • Hi Jason,
        Suboxone isn’t a very strong pain medication.
        It depends on your medical history, so I’m afraid all I can tell you is to talk to your doctor.
        Why are you on Suboxone? If it’s because you have addiction in addition to chronic pain, other opioids are obviously going to be very high-risk medications.
        Jana

  4. Posted by Marie on May 28, 2011 at 3:52 am

    How refreshing it is to see a Dr. that truly gets it. Bless you.
    This is my second time on Suboxone and I’m trying to do it differently that I did last time. I have been to rehabs several times.Like everyone else I have a long story and have struggled with pain and a chronic illness.

    I only wish there were more Dr.’s like your self that treated us like any other pt. We didn’t choose to become addicted to pain meds. It’s not like we woke up one morning and make a decision to mess up our lives over damn pain pills.

    It’s Dr.’s like yourself that can get the message out and i know I speak for many that I appreciate you and your time and heart that goes into helping other suffering addicts.

    I have not read the entire blog yet. I just found out about it from another forum of a lovely lady that runs it.

    I did ssee someone say about a book u may have wrote. I’ll try to find that.

    Thank you for all you do.

    Marie

    Reply

    • Thank you very much. For some reason, I’m passionate about educating people about the benefits of medication-assisted therapies. This is odd, because years ago I learned that abstinence- based, 12-step recovery was the only real recovery. But when I dug into the research, I was amazed by the number of studies showing benefits from methadone, and now buprenorphine. We’re talking 45 years of studies, and the treatment community seems to ignore all of it. That’s not right, and it’s not good medicine.
      And just like 12-step recovery isn’t for everyone, medication-assisted treatment isn’t right for every opioid addict. If an addict can do well without meds, great. That’s the ideal. But no treatment works for everyone, and these two medications can be life-saving. Yes, they also have disadvantages. but what medications don’t?
      I do this blog because I’m struck by the judgment and unfairness that people, in excellent recovery on medications, have to face from family, law enforcement, medical professionals, and even treatment center personnel. It’s not about right or wrong. It’s about what works.

      Reply

      • If the government regulated the use of cars the way they do pain management drugs, in many states no one would be able to set foot behind the wheel of an automobile and drive. As a nation, our Puritan roots still compel lawmakers to focus on the people who are misusing drugs instead of those who are managing them well because they are very ill or are suffering from post-surgical pain or damaged nerve pain that will be chronic for the rest of their lives. It is ridiculous in this day and age, when there are so many other more important ills in the world for people to focus on, that pain meds used regularly by physically ill people should even be a topic of conversation. Every human being in physical pain deserves relief–animals too, the mentally ill and needless to say children and people who have not yet obtained citizen ship. There will always be a sector the population who abuse pain killers–that is a fact of life. It should not be given so much importance that people who use them for physical pain who handle pain meds without overreacting to them and do not throw their lives down the drain when in possession of pain meds are lumped in with people who simply go crazy when they get near pain meds. Anyone who cannot handle pain meds WHEN IN PHYSICAL PAIN obviously needs help taking them in a supervised way or controlled environment. But they qre the EXCEPTION to the rule and their needs or misdeeds should not impinge on the rights of ill people whose reputations can be severely damaged when people learn they need pain meds because of a physical condition. Someone should write Alan Dershowitz about the rights of successful pain medication users and the damage to their self-esteem and reputation that can result because every doctor is being forced to work in tandem with the lawmakers–are they police or health practioners?

  5. Posted by Marie on June 12, 2011 at 6:11 pm

    Dr.Jana,
    I’m hoping you can give me a answer I desperately need.
    I’ve been on Suboxone for 2 1/2 months and this is my 3rd. Dr. I will be going to this week. The first one took my Ins. but there were MANY issues and I’m pretty sure he will be on the news before long.
    The next one I went to I had to pay for only for him to tell me I had to go every week at 200.00 for 6 weeks.
    So,I found a Dr. that actually called me and spoke with me. I have to pay her cash and she is not close by but if she is good i’ll deal with it. My problem is,she told me she does not have a Medicare number. I’m on Humana/Medicare. I assume that means I will not be able to submit a claim form to get my money back.
    My problem is,I’m concerned this is going to be a problem for me when I go to fill my Suboxone. I didn’t think anything of it until she told me she didn’t know i I would have a problem or not when I went to fill it since she has no Medicare number. I have been approved for the Suboxone after I went thru a Appeal after being denied.
    There is no way I can pay for the Suboxone. I did that for 3 weeks waiting for my Appeal to go thru and that has hurt me badly financially

    Do you know if that is going to be a problem? If so,I have to know beore I go. I’ll have to go back to calling Dr. after Dr. again.

    All I want is to get stabulized so I can start counseling and try to move on with my recovery. I’ve been so stressed over all this I’m not even eating.

    I didn’t have any problem with any Dr. taking my Ins. when I was on the opiates and now I keep running into one wall ater the other.

    Any help would be greatly appreciated.

    Marie

    Reply

    • Hello Marie,
      thanks for writing, but I don’t know if Medicare will pay for your prescription or not. I’m betting your pharmacy may know the answer to this. If they don’t, I’d call Humana/medicare. I’ve had patients who encountered similar difficulties. One patient had Medicaid in another state, and they will pay for the medication, but only if prescribed by a doctor who is licensed in that state.
      One of the biggest obstacles to treatment remains the costs. Between the doctors’ visits, counselors, and medication, it adds up quickly.
      But don’t get discouraged. You can still go to 12-step recovery in Alcoholics Anonymous or Narcotics Anonymous, since they are both free. You may not want to mention you are on medication. These meetings can help you stabilize.

      If you can’t find any affordable Suboxone treatment, please consider going to a methadone clinic. Methadone’s been around for 45 years, and it works when done correctly. The priciple behind methadone is the same as with Suboxone: both are long-acting opioids that can be dosed once daily to prevent withdrawal and block other opioids.

      For information about area Suboxone doctors, you can go to http://buprenorphine.samhsa.gov

      Reply

      • Posted by Jason on June 28, 2011 at 9:28 pm

        Dr. Jana,
        Can Suboxone Doctors also prescribe methadone? I’m looking for a way to afford treatment, and after 2 years of payng cash for Suboxone, I just can’t afford it any longer. Also I am unable to go to a clinic every morning for methadone.
        Thank you!

      • Any doctor with an appropriate DEA license can prescribe methadone to treat pain, but it’s illegal to prescribe methadone from a doctor’s office if it’s meant to treat addiction. That’s because of the risk of medication misuse in people who also have addiction, and the dangers methadone presents due to its very long half-life. Methadone can only be prescribed for the treatment of addiction through properly licensed and registered Opioid Treatment Programs – that is, the traditional methadone clinic.

  6. Posted by J on July 8, 2011 at 5:51 am

    A friend recommended your blog. Thanks

    Reply

  7. Posted by Jackie on August 21, 2011 at 11:28 pm

    I became addicted to opiates after I started taking them for my endometrios. I went through detox and have been clean for 32 days now with the help of NA. I am just getting my first period since getting clean and am terrified of the pain since I cannot rely on opiates for pain relief. What are my options?

    Reply

  8. Posted by Steve on October 12, 2011 at 3:40 am

    I haves been on suboxon for a year. I have a terrible toothache. I have tryed everything nothing helps. Can’t get it pulledright away. Can I take a pain pill until then?

    Reply

    • There are several ways of managing your dental pain. But you need to call your doctor and follow her advice.

      Reply

      • Posted by Roy Lane on February 3, 2012 at 10:07 pm

        I had a toothache myself and had to have it pulled my suboxone Dr. agreed to let me have them and the pain meds work. You just don’t get ” high ” on them. And don’t take them both at the same time.

  9. Posted by todywife on November 21, 2011 at 9:27 pm

    I’m sorry I didn’t clarify. I was at the clinic for a year the first time and at 140 mg. I left and came back. That’s the second time around (now) that I’m at 95mg and they are telling me I’m too high.

    Reply

    • Thanks for clarifying. There are so many variables that I don’t know what to make of your case. I think you should meet with your doctor and outline all of this information, especially that you’ve been on a higher dose and apparently did well. Methadone leves help decide that appropriateness of a dose, but it’s not the only thing to consider. If I were your doc, I’d want to see you just before you’re due for a dose, and three hours after you dose. That way, your doc can see for him/herself if you’re sedated at this dose.

      Reply

  10. Posted by Rebecca Ibarra on November 23, 2011 at 7:12 pm

    i am 28 years old. i have been going thru pain pill addiction for two years and i have hit rock bottom and i still cant stop. i had my husband take all money from me but i still find ways to get money. i have family support and i want to quit but i cant stop the urge i am so afraid that i will lose everything in my life if i cant get thru this. please give me some advice.pleae

    Reply

  11. Posted by Jason on November 24, 2011 at 1:24 am

    Rebecca, I was where you are and I can tell you that Suboxone gives you your life back almost immediately. I didn’t/don’t crave the pills anymore and I remember being SO relieved that the ‘pill chasing’ was over..for me right away. Suboxone (especially the first two weeks or so) makes you feel so good and you will have energy that pills never gave you and you will finally sleep like you used to..it’s amazing. We’re in the same boat, only now I’m taking Suboxone. I do feel dependent on it, but nothing like the pill chase and the fear you have when you start running out. Please go to a Sub doctor or the treatment center Dr. Jana metions. Good luck and keep posting your progress so we know you’re ok. Jason

    Reply

  12. Posted by todywife on December 19, 2011 at 1:17 am

    So they put me put me up to 110 milligrams and said I couldn’t go up any higher til I saw the physicians assistant. he tested my mental health my physical health and ask me if I was burning the candle at both ends. None of that is making me withdrawal so he grabbed a piece of paper and did a test of withdrawaling.you could score 0-3 of every question and out of 30 I scored 14 so he will put me up 5 milligrams of a week until I get to 125 n then I have to do a nother peak and trough. does this seem logical? I don’t understand what he is trying to get at. I was so sick that morning I vomited at the clinic. I just hadn’t dosed for 26 hours. what is going on with me? is this normal? Please help!!

    Reply

    • Posted by todywife on December 20, 2011 at 1:04 am

      I will continue to talking to them.I haven’t exaggerated any of my symptoms because I truly want to get help. I’m not looking at a number to make me feel better, but I honestly feel withdrawal at this point. I just hope that we can all agree on this. I don’t wanna be perceived as drug seeking at all. That’s not my reasoning for wanting to go up.it wouldn’t matter the number whether it was 10mg or 200mg as long as I’m comfortable to handle on my daily stresses I will be satisfied. I will keep you posted and thank you for all your help. Bless you have a happy holiday season

      Reply

  13. Posted by Sam on January 11, 2012 at 6:20 am

    Just finished up a year of hell with my pill addict son. His addiction came as a complete suprise to us – he was a college student, athlete, a good kid who we never had problems with. So the sadness over this is unbearable. I feel like the son I knew is gone. We got him started on Suboxone and counseling, which seemed to help for about 3 months. Since then he’s been on and off Suboxone, using, stealing, lying etc … a familiar story to many I’m sure. His life has spiraled downward. I don’t understand why Suboxone doesn’t work for him. I guess I was looking for a magic potion or something. It has been exhausting and the joy has surely gone out of our lives.

    Reply

    • I am a recovering drug addict and have been clean one year I was using for seven. Suboxene is really only supposed to be used to help with the withdrawals and to keep the strong cravings at the beginning, but slowly taper off. In my opinion as a person In recovery he doesn’t need meds because it takes more than that you have to find the root of the void he is trying to feel by using. Na was a huge help to me because it showed me I was not alone or judged of my struggles and successes. Drug addicts and alcoholics are wired differently then someone who doesn’t abuse. And it’s ok to go to a meeting high in the beginning because you don’t go to the doctor cured right? Get him in a meeting and create a huge support group and remember to take it one day at a time.

      Reply

      • Also two it really does not matter if he was a good kid or bad kid addiction is hereditary and sadly it was in his genes before he knew how to crawl, if you have any questions I would love to help, I will gladly give this gift of hope as it was so freely given to me

      • Thanks for writing, and I’m glad you haven’t had to take any medication. But Suboxone works best when it’s used as a maintenance medication. We saw this as early as 2003, when a study of 40 patients showed that when Suboxone was used as maintenance, the majority of that group was still intreatment and doing well at the end of the first year. But the group that was on Suboxone for a six-day taper had no patients stil in treatment (recovery) at one year…and twenty percent of them were dead of a drug overdose.
        People are so different. Some addicts do fine without meds. And some need Suboxone to replace the endorphins their bodies should be making. I do think medication-free recovery is the ideal, but that doesn’t work for every addict.

  14. Posted by nancy solt on March 30, 2012 at 3:50 pm

    I have been on a Suboxone treatment plan for a year now after being on very heavy pain medications from Knee replacement and eventually amputation surgery. I have done urine tests occassionally at the docs office, however this last time it was a totally different test cup, there was no lid on it and on the boton it had a urine line and then had this strip, when the urine was in there the strip said “look for the green” there was a hint of green, I had no idea what it was. I went back to the room, waited for the doc, he came in and asked me to be honest with him, if there was anything I had done that would cause Methamphedomines show up in my urine, I was blown away, I had never done that in the past first off, and have not had any pain medication for about 6-7 months, since my last admittance to the hospital for 4 days, they made me feel like total crap. They said they were going to send my UA to a lab back east, they would not have results for about a week and from there, if it shows I have done that they will remove me from the suboxone treatment plan. This is such BS!! I came home and tried to figure out what the hell could it be. I have taken excedrin for headaches, excedrin cold and sinus, I think maybe once or twice, however I have been trying to lose weight as I am quite large, me and my daughter bought the over the counter HCG diet at walmart, that did not work so I bough Hydroxycut, I have not taken much of that either. Could any of these make my test as a false positive? I need some peace of mind with this, I feel like I am having to fight to prove myself right and this is just awful! Someone please help me. Oh- I also took Aleve.

    Reply

    • I’d wait for the second test, and try not to worry.
      However, I have seen patients with true positives from stuff they get at the vitamin stores. There’s not much regulation of those products, so it’s a bit of a crapshoot when you take them.

      Reply

    • Posted by Holly on August 20, 2012 at 10:31 pm

      I tested positive too for methamphetamines twice when I hadn’t done any. The first time, my suboxone Dr. sent it to a lab–it came back a false positive, but he didn’t tell me what caused it. The second time, he asked me if I had taken anything for acid reflux or gas or any other drugs, over the counter or otherwise. I said yes—I sometimes take my mother’s ranitidine when I have acid reflux. He said that is it…Ranitidine will cause a false positive, as well as other drugs. He didn’t tell me what the other drugs are that could cause a false positive. Maybe you can find out what they are and see if maybe you took one of them.

      I freaked out when mine came up positive for meth, since that was my drug of choice and my doctor knew it. Knowing I hadn’t done any, I knew it would come back from the lab as a false positive.

      Good Luck.

      Reply

      • It depends on which lab or test kit your doctor uses, too. the inital test is an immunoassay, but they vary depending on the manufacturer. In any case, unexpected results should be sent for confirmatory testing, like your doctor did.

  15. What kind of clinic do you own or work at? Colonial Mgmnt Grroup owns the one I go to, and their practices are nothing, and I mean nothing like what you are describing here. We, the 2000+ patients that go to this particular clinc, don’t come near a doctor. That is unless it’s our yearly physical. What’s more is that I have never seen the same doctor from year to year. I like to call him/her, “the doctor without a face”. It’s a shame, because I might have come out of this with a different opinion.

    Reply

    • Please see my reply to your last post for some solid information. Yes, clinics do try to retain people in treatment based on the data that shows bad outcomes for patients who leave. However, if you look at the NIDA web guide on methadone treatment you’ll see that the best clinics also evaluate each person as an individual. for example, if you have a 5-year history of opioid addiction but managed to stay clean from all opioids for a year during that time, meaning your history of dependence was interrupted, you probably will be able to successfully taper off and stay clean because you did it before. But your clinic must work on relapse prevention before you’re off methadone.

      And you are right – many methadone clinics are owned by large, for-profit companies. Does that make them bad clinics? Not necessarily – it depends on how they are run. If clinic owners pressure the people working on the front lines to “keep the numbers up,” meaning keep making us profits, that’s bad. Ideally, non-physicians shouldn’t control the practice of medicine. Is that the way it is in real life? Sadly, no, at least not in this field, as I’ve learned from unpleasant experience.

      I’ve worked at 12 clinics over the past 11 years (one place had 8 locations). I’ve worked at for-profit and non-profit, and the non-profit did not deliver the best care of all. The best clinic is one where I’m working now, Stepping Stone of Boone. I’m allowed complete authority to do what I do best – be a doctor. But this is a very unusual clinic in that its owners are all people who live in the Boone community and who have a passion for helping addicted people regain their lives. That may mean staying on methadone or buprenorphine permanently, or it may not. Obviously, the patient is the one who makes the decision. If a patient wants to taper, we talk, and we discuss the best way to do it, taking into account physical/mental health issues, other drug use, how much counseling they have they had, etc. We have an adequate number of counselors for the number of patients (very important) and we also offer buprenorphine, though it does cost more than methadone. We’ve had some buprenorphine patients do so well that I switched them to my “X” number and write Suboxone prescriptions for them, which makes life so much more convenient for them.

      The bottom line – vote with your feet. if you aren’t getting good care, look for another clinic. The big problem is that there tend not to be very many clinics in many areas, leaving patients with only one choice.

      Also, be honest with yourself – have you asked to see the doctor? Have you done your part to get counseling? In many clinics, if the patient seems disinterested in doing anything except getting the daily dose, the counselor may not make an extra effort to talk with you. Some patients even get angry if counselors push them to have sessions! Your counselor isn’t going to work harder than you do at your recovery.

      If you don’t have an available doctor, that’s a problem. Each clinic should have a medical director. I think it would be unusual if the doctor wasn’t there nearly daily for a clinic of that size. At Stepping Stone, we have 130 patients, and I’m there in person at least 5 hours per week, and always available to staff by phone. I spend a few more hours per week looking at patient data, talking with staff, looking at how our policies/protocols are working. I’d think you’d have a doctor at a minimum of one day per week, surely.

      Reply

  16. Dr. Burson I have one more question that will I hope lead to more questions, but not here. I know that you cannot treat me without seeing me, but still I have some general information that I think you could give me. I have looked everywhere for an email address for you, but cannot find one. Is there any way you could email me @ purplerain@ismelltherain.me so I could correspond with you privately. You can delete this if you’d like, but I hope you don’t without at least emailing. I’ll make a deal (if you’ll accept)- if you do, I’ll buy your book AND read it. :) See, we both help each other. Thx for all your previous help. Aashton

    Reply

  17. Dr, Burson, I have corresponded with you a few times and you have helped me indirectly a thousand times. Just quickly I am the one that had qtc prolongation needed high dose methadone a hard stick so many failed attempts at Peak and trough’s etc… I went to an cardio doctor and it turned out I do not have the qtc problem after three separate ECG’s. I have a 390 score so I was able to increase to 210 milligrams and split dose. My life has been wonderful since then. I only needed an additional 30 milligrams and split dose.to make all the difference. Now I have a real scare going on and I need some advice. I AM SCARED.

    I have been having problems lately with a stone in my common bile duct and I have had to go to the hospital a few times when the pain got too bad for me to handle. Well since my last visit to the E.R., I have been to my general practitioner at a low cost clinic we have here in my town where I have formed a wonderful relationship with a doctor. He is the doctor that found out I did not have the QTC Prolongation (torsades des pointes) and he is very supportive regarding my being on methadone. Well he has been over seeing my stone situation and was referring me on to a gastro doctor when he found on a CT Scan taken a month or so ago, I had a mass in the right upper lobe of my lung. Apparently when the radiologist saw it he went back a few years to an old CT Scan from back in 2007 and compared the two where in 2007 it was called a “Nodule” not a “Mass” and so he commented on the dictation notes that it was a bit larger since 2007 making it a Mass now not a nodule.

    I had obtained a copy of all my emergency room visit records to include labs, CT scan on CD and doctor notes for my GP doctor so I found this noted problem on the CT scan dictated report myself firsthand. I read this a few days before my appointment with my GP, and yes it worried me but one would think if it was real serious…it would have been brought to my attention in the E.R. that day and I didn’t get overly excited thinking I would have been told that I had better follow up with a pulmonary doctor too not just a gastro doctor, I mean what if I wouldn’t have stumbled upon this by being nosy about what my records, lab test and ct scans had to say????

    Nonetheless, I took all these records to the GP and I did not want to make any big deal out of it to deflect away from my painful stomach issue so after the doc and I talked the stone issue out I handed him the CT Scan report and ask him what he thought about the report stating that compared to a CT scan in 2007 a noted nodule had increased in size some. I also had a CD with me that had the actual Scan images on it from 2007 and the most recent CT scan too but the report only mentions the nodule/mass issue very briefly, nothing sounding too urgent etc…..so my doc was pretty cool about everything and said we might want to look into this as soon as we get the stomach issue under control as he knows I can’t really afford the specialist referral monetary cost times two I guess. Meaning I can’t afford office visits and testing by both a gastro specialist and a pulmonary specialist. He did say emphatically we needed to get it looked into though but we will focus on the immediate need of the painful stone issue first.

    So once again I am thinking if it was “real bad” I would have been more urged and even made it necessary for the pulmonary being the primary focus before the urgency of the stone issue. But he said what he said briefly and then he went back to talking about my gastro issues and said he did not like the way his self pay clients had been treated by a local gastro doctor so he was going to call over to Asheville and find a gastro doc that would work with on a low budget self pay status and get back with me asap. I leave and go home with a new appointment to return in one week after he gets some bloodwork results he drew on me that day.

    Well a day or so after my appointment I get a call from a Doctor here in Hendersonville which should have been a clue as he said the gastro would be a Asheville Group but anyways this nurse says that she had spoke with my Doctor and they had made arrangements for me to be seen on a lower fee arrangement with a contract to pay as much as I can etc…and we made an appointment for Tuesday, June 12 at 3:00 pm, less than a week away. I am thinking wow great and how quick he got it all done and did as he promised. I am feeling so positive about it all….. Until I return to my GP to discuss that bloodwork he had drawn on me and find out this phone call and appointment I had received a few days ago is with a pulmonary doc not a gastro doc. I never clarified any of this on the phone with the nurse because he had said we would wait on the lung issue. I was confused now but he explained the reason being he had a change in the more urgent need being placed the lung issue being a more urgent need now than the gastro after he actually viewed the CT Scan on the CD I had left with him that day (last week) and when he looked at the scan images he saw that directly beside the mass/nodule that has changed in size just a little bit since 2007 is a lymph gland/node, namely a “Hilar Gland” and it is enlarged/swollen and this concerns him and puts my urgency status with my stomach on a different note as far as what’s most important between pulmonary or gastro etc…This was not a complete shock to me as I was already questioning it in my mind the CT Scan dictation report that I read myself, but I must say this set me back a bit and scared me too.

    I didn’t know what to think or say at that moment except……OMG do I have cancer? He told me that is why I am going to the pulmonary doc. I ask him what exactly had made the sudden urgency change other than his response to me last week and he stated the enlarged gland was not mentioned in the dictation report but after he got caught up that day after I left he sat down and viewed the images on the CD I left with him. He was not comfortable with what he saw in the enlarged hilar gland and so he then took it to the lead physician where and when they both became concerned. Like I said earlier, the dictated note on the CT scan did not even mention the hilar gland enlargement which it should have. He went further to say moreso importantly was because the swollen or enlarged hilar gland is located right next to the nodule/mass and this created even more concern. He said last week he felt a need for caution but now after viewing scan his caution is now concern.

    WOW. It’s been about 6 days since this happened and I have not talked about it to anyone really…maybe my Husband a bit because I am too scared to talk about it to any family or friends. My hysteria is all I can handle right now, Not my mom’s etc…. I have been determined not to get on the internet in frantic research and just WAIT but yesterday I was about to bust so I had to find something out to hopefully give me some peace and/or comfort and from all I read I got neither and I am even more afraid than I was when I left my GP’s office. It appears to me that I have more of a chance of it being a cancer issue than not. And….a biopsy will probably be in order to find out for sure so today I have research what a biopsy is and how they are administered to find out there are four types and all of them sound scary as hell too.

    OMG and to make matters worse guess what??? I realized I already know/knew this doctor and he and I had some serious words regarding his treatment of my father in law two years ago. He was an Ass…A Jerk….Can it get worse? Yes I am sure it can like…. Will I go there Tuesday (tomorrow) and he might do that needle biopsy in a back room in the office with just Novocain??

    All Day yesterday, I spent in consideration that I may have cancer, either lung cancer or lymphoma from what I have read and so today I have spent all day in panic and wonder of now if I do have cancer or concern of cancer what about the fact I have no insurance? Will I get compromised treatment, less than the best? Will they cut cost/corners with me because I have no way to pay for better or more comfortable test? Will they tend to do cheaper testing like that needle biopsy instead of knocking me out? If someone with no insurance gets cancer can I apply for some emergency medicaid etc????

    Then when I am not freaking out about all this I am thinking and panicking over my MMT. Do I risk losing my MMT status? Do cancer patients get to continue their MMT? Will the clinic detox me???? I am beside myself Dr, Burson. I go from freaking the —— out inside to accepting my possible fate wavering back and forth with the only stable constant feeling I have is a constant desire to GET HIGH. This is just me being honest. I know getting high would be making matters worse, but the addict in me just wants to get a bunch of opana’s and just forget about it all for a little while.

    I wasn’t going to post anything to anybody etc….but I can’t stand the feeling of lonesomeness and frailty. What can I do? What can I expect? My biggest fear being my addiction killing me before the cancer if I can’t remain on MMT. Will they just expect me to focus solely on the cancer, stop the MMT and risk my getting high? If I lose my methadone in this kind of state (cancer) I am doomed to get high for sure. Because in these circumstances I am sure I will get high without the methadone. Hell I wanna get high now and I am on 210 milligrams of methadone.

    I know you must be thinking I am crazy to worry about the methadone issue if I have cancer looming over my head but I have no control over what all I am feeling, thinking or assuming. I have broke down a few times and smoked a cigarette here and there as stupid as that is. Smoking is by all rights the culprit, but my body was raging those times. I got on the patch yesterday and still had one cigarette.

    I know I appear as a freak out worrier and drama queen and yes, I am guilty of all but I need some good solid advice and information. Please pick a topic or better yet pick a few…Cancer…being on Methadone if cancer…..biopsies…smoking…getting high….help me with some answers. ANYTHING WILL HELP IT CAN’T HURT.

    Reply

    • Oh gee. First of all, take a deep breath. Stay in the moment and try not to assume the worst. The fact is that you don’t know what this is – and probably won’t know until the doctors do more tests, which will be a while. You are going to have to live with uncertainty, which is difficult for all of us, but do-able.

      On the bright side, I’ve never seen a lung cancer patient have lung cancer for 5 years without any treatment – surely it would have killed you by now, if it was visible in 2007. Still could be lymphoma or ten other things or turn out to be nothing at all. You just can’t let yourself get into the “what if’s” right now, because there are just too many possibilities.

      as far as cancer in methadone patients – generally if the patient is still able to come to the clinic, they come to the clinic. If they get terminally ill and unable to come to the clinic, I’ve had Hospice take over, and they provide supervision over whatever opioid is prescribed. It may be methadone, may be something else, but that’s a decision that should be made by all of the doctors talking together. I have a feeling you will not be faced with this though so don’t waste time worrying about it.

      by the way, if you have to have some expensive tests, you can get Medicaid once it gets up to a certain amount, then they will go back and pay retroactively, from what I understand. I’d check into that. If you need a bunch of tests it could actually qualify you for some benefits with Medicaid health coverage.

      Biopsies – cannot be done without your informed consent. It depends on what kind of biopsy is needed as to how much medication you would need. I’ve had a bronchoscopy done while I was in med school, no sedation, watched the whole thing on a teaching scope but then I’m a nerd so it completely distracted me. Lung biopsies are done with numbing of the skin, maybe some sedation to prevent anxiety. Just make sure your doctors know you’re on methadone.

      Look: your big problem with the methadone dose, QT interval stuff, etc worked out beautifully. Maybe it would help to believe this will all work out too – though if you do have a common duct stone, I’ll bet that sucker’s gonna have to come out.

      Please keep us updated. I’ll be praying for you.

      Reply

      • You were right…All is well besides something called interstitial lung disease from smoking but I have quit now for quite some time. I got approved for level 6 now the two week takehome phase and I am ecstatic as it’s not as far as a drive as some people make my travel time is a good 45 minute ride from where I live here in the NC Mountains.

        I wanted to mention something though. My clinic was one of the last Benzo tolerant clinics around here until a few weeks ago. Now we no longer accept anyone positive for benzo’s even with scripts….If they show positive in the admission process they are told to detox off and come back but no admission for at least 30 days. The already admitted clients have to drop their dose to under 100 milligrams or given 30 days to detox off benzo’s. The no scripts clients were allowed to flunk screens but they had to forfeit takehomes but now under new policy they are being detoxed off after one more failed drug test. We still allow pot smoking but the pot smokers forfeit takehomes but my clinic is feeling the heat of mixing benzo’s and methadone. Why?????

        Well, sadly to say we have lost 3 patients in 90 days that can be directly related to benzo/methadone toxicity. I was wondering your clinic’s view/policy on this??? I myself learned way before I knew what methadone was how dangerous Xanax was and suffered over a year detox off them back in 1990. That horrible detox seared/burned a “never again scar” in my mind that I have never touched them again so Thank goodness I do not have to struggle with this myself. I feel for the clients that have PTSD or panic disorder as years ago I suffered the panic disorder and…when I was at about 80 millgrams of methadone during induction I had a three week or so scare with panic disorder as a reminder of how debilitating panic can be. Thank God my counselor was right when he told me to hold out for stabilization that I was probably just having a temporary setback since my lifestyle (selling, searching and buying opiates) had changed so drastically to a place where I had a lot of time on my hands and the drama content was “in mourning” going from illicit use to maintenance use and sure enough when I got more stable it went away. But it was terrible for those three weeks so I feel for the person who has to deal with such.

        I have found in listening to all the jibber jabber at the clinic over the new policy we have some die hard benzo users. Most that I have talked to are going for the detox of methadone instead of detox off benzo which I can’t relate to at all. In the last month we have only had 11 admits which we usually have at least 5 to 7 a week. I was just wanting to share a clinic story and wondering about other NC clinics.

  18. I am a recovering lortab addict, who also suffers chronic pain. Pain is a huge trigger for me, and I managed without mood altering meods for my first to yrs of recovery. It got to the point I was afraid I would get so frustrated I would end up trying to relieve pain “my way” My pcp is experienced and knowledgable about methadone, and prescribed it to treat pain. She only writes 2 wks quantity, and monitors me closely with screens and random pill counts. I am able to function and work, and I have my life back. I wanted to tell you my story so it would be understandable how very grateful I found your blog and that there are people like you in the world! I hope to never return to a life of active addiction, chasing, and trying to stay supplied on 30 pill a day habit. It is really not a “life”. I want to stress that my dr uses this to treat pain, not my addiction. I have a counselor, sponsor, and fellowship to treat that. Every piece of factual wisdom shared here adds to the probability I will still be in recovery the next day I wake up. My only worry is in 3 yrs my husband retires and we plan on moving to Alaske. I currently reside in small town Indiana and it was difficult to find a health care provider who did not have a fear of methadone induced by the media. I dread having to find one in Alaska, but try to stay in the day, when I get overwhelmed. Anyway, I appreciate all that you do, and am so grateful there are people like you in this great, big world. I appreciate your work, and sincerely mean that, from the bottom of my heart. Thanks again!!! A woman in a little town, Indiana : )

    Reply

  19. Is there anything, along the lines articles or literature you could recommend concerning treating chronic pain in recovering addiction (vs. active.addiction) or something to take to educate doctors and dentists? Methadone has such a stigma that I procratinated sharing theinfo about my being prescribed this, to my sister who is a familyNP.She has been my biggest support and also suffered losing her sister to a pill addiction. She was wonderful tome, but I am her sister, not her patient!! Thanks so much!!

    Reply

    • I’m so glad you’re doing well. Studies show high relapse rates for patients with opioid addiction who are prescribed opioids for chronic pain (up to 46%), so i don’t think they will help your case. I think your best tactic is to make sure your former doctor sends a letter saying how well you’ve done in the past. But I agree, that’s going to be a hard sell. Maybe you could agree to once weekly prescriptions for more accountability – more cumbersome, of course, but it may ease some of your new doctor’s worries about medication misuse in a relapse.

      Reply

      • Thankfully, I have done well. I was terrified of starting on this when my doctor first mentioned it, and tried this as a last resort. I take 10 mg twice a day, but I was scared of having to go through anything close to how my life was during active addiction. I think that just having a doctor I can be totally honest with, that I can email anytime and will contact me the same day, that I know does not treat me differently because I am an addict makes all the difference in the world. She knows my addiction is serious, but she makes me feel no different than if we were discussing my cholesterol or allergy. I am an addict, but I also have brown eyes-cannot change either fanct, LOL! I wish more drs were that way. Maybe if all of us try to be open about it and let drs see an addict is just an everyday person- a teacher, housewife, fireman……not just a stereotype. I worked in a dr office about 15 yrs ago, and I hate to admit it, but I did stereotype addicts and alcoholics until I realized I was one. I made a promise to myself that I refuse to be ashamed of being an addict- I had no control over it, much like I did not choose the color of my eyes, but my recovery is something I am very proud of. I have had drs who instantly changed the second I said the word addict, when I mentioned being a recovering addict to one doctor he wanted to refer me to a mental health center and would not even look at me. I almost cried. Is there anything else, you, as a doctor, could recommend for us to do to help drs, dentists, and nurses be more comfortable and open to discussing addiction ( especially prescription drug ) with us. I try to be open in the beginning, but a bad experience like I had can make me wonder what is best to do?!? Any other ideas? Thanks again!!

  20. Oh BTW i also want to mention that Hendersonville (my hometown) finally got a suboxone clinic…No methadone clinic yet but we are getting more with it and not so closed minded I hope.

    Reply

  21. This is not a post to condone or condemn those using methadone to treat opioid addiction. Instead I would like to offer some hope to those wanting out. What I will say without going into great detail is that it is possible. I believe it became possible for me when my desire to be completely sober, outweighed my fear of living without medication.

    I spent 20 years on pain pills and eventually methadone. The road out was not easy, but it was necessary. It was necessary for me because I knew I walked myself into my situation, and I would walk myself out. I have never been a religious man, though I cannot deny I had spiritual help. I can’t explain it other than to say when I was at my lowest, I knew I was beling helped.

    My biggest fear was the unknown. I couldn’t find anyone to physically speak with about the crazy torrent of emotions passing through my head. I just wanted to talk to someone who had experienced what I was feeling, and to know I was going to be alright. I never talked to anyone, but I am 48 days off now and feeling wonderful. I will never say it was easy, but what I can say is every bit of the pain was worth it.

    If anyone ever reads this and feels that fire burning inside, please don’t let it die. I have thought many times about what sobriety is and how best to accomplish it. Lucky for us, there are many ways people have succeeded. No one way is best. However, I think it all comes back to inspiration. Can you muster the amount of inspiration needed to push you through?

    If you do get that inspiration and feel the need to speak with someone who has been where you are going, Dr. Burson will have my cell and/or email address. I have learned many things over the last year that I wouldn’t hesitate to pass on. Life is such a gift and we have one shot- we must all make it count.

    ismelltherain

    Reply

  22. Posted by krissy on September 15, 2012 at 6:52 am

    hello, my name is krissy. i actually came across ur website, wile i was googling “is it illegal for doctors (mental health facilities), do not accept u as a client if u are currently in treatment in a methadone clinic? also, since unfortunately i recently had to find a new m.h. provider after 4yrs. in treatment & on meds., that i was doing quite well on!! this new m.h. provider & i went over some of my past history, dx’s, & current meds….as well, as previous med. hx. all seemed to be going well with our 1st meeting, until he came upon the section of my pkt. of questions i filled out…& the dr. saw that i was in an outpatient methadone maintence program!! i honestly felt like i was a criminal, with how he then began to treat me!! he told me i was a liar, because when he was asking about street drug use..1of the questions was “had i ever done heroin”, i told him no…which was not a lie! im in treatment due to prescribed pain med use…that i couldnt stop on my own! this doctor proceded to tell me im a heroin addict & i lied to him, he called me suspicious, he called pharmacys that i told him i used to verify my medications, which i had no problem with…until he stated to both pharmacies that “he was calling regarding a suspicious patient he has in his office, & wanted to verify if i was on meds. i told him, etc.!! he also stopped me on 2medications that i have been on the last 4yrs. the medications being: clonidine 0.1mg. 3tabs.@ bedtime, & dextroamphetamine 10mg 4tabs. daily for

    Reply

    • Posted by krissy on September 15, 2012 at 7:13 am

      this is krissy…my post cut me off, & i just wanted to finish last part of it…im sorry! lol back to the meds. dr. took me off of cold turkey (after 4yrs. of doin well on the meds.!) was clonidine 0.1mg. 3tabs. @ bedtime, to help with my sleep. & dextroamphetamine 10mg. tab 4x daily, for my ADD. i have been a wk. off these 2meds. for a wk. now, im noticing alot of changes…none of a good feeling orbenefit!haveletters of compliance from my primary counselor that i have given m.h. dr.! why is does it seem no other healthcare providers, want to help

      Reply

    • Hi Krissy,
      I don’t think it’s illegal for a doctor to behave in the manner you describe, but it is unethical, in my opinion. I feel depressed when I think of how many psychiatrists aren’t educated about methadone. You didn’t hide anything, and yet still got branded as a “suspicious person.” that’s sad.
      I’ve had patients tell me similar things and with their permission, I’ve tried to call as an advocate for the patient. The opioid treatment center is focused on treating drug addiction, and the patient may need help with other mental health issues, so our center has told them to get psychiatric help. then when they do go, they get rejected. At first I thought naw, the patients are exaggerating. They weren’t.
      I talked to a psychiatrist who refused to continue to care for a patient who started on methadone even though he’d been seeing the psychiatrist for almost a year. When I called to ask what her objection was, she said methadone “Was the opposite of everything she was doing to help the patient.” Mind you, she had no problem prescribing hefty doses of Xanax for months on end. I tried to get her to be more specific, as her answer was so vague I didn’t understand but she couldn’t be more specific. That’s often the case when you ask people why they object to methadone. they say things like “I just don’t believe in it.”
      Your new doctor may feel like the amphetamine was too risky for someone with addiction, but I’m puzzled about the clonidine. That dose may drop your blood pressure during the night, though.
      Have you considered making a complaint to your state’s medical board? What you describes sounds like your care didn’t meet the current standard of care.

      Reply

  23. Posted by Jeannie on September 25, 2012 at 8:04 pm

    I am a 55 yr old female who is currently addicted to vicodin. I informed my dr of this and his answer to this was to cut me off. I live in Mohave County Az and can not find any drug treatment as far as detox. I went to a methadone clinic and said I did not meet the criteria as they thought I could just stop taking 10 pills a day. I was actually told to take tylenol and energy drinks to get thru it. I am on state insurance so it is very limited in Az. Even with insurance of my own there is no detox available. I have signed up for substance abuse counseling however they informed me they could not help with detox. I really do not want opiate replacement other than a short detox aid. I have tried over and over to go cold turkey but I get so sick I can not bear it and I work full time. I have never been or felt so desperate before. I almost feel like going to the er and saying I am going to kill myself so I can get help. I don’t want to kill myself however and that seems pretty intense to go to that extreme. I did look up on the treatment locater and every dr listed which was very small were no longer in this area. I just can not believe that someone who honestly desires help can not find it. I have spent alot of time looking also. Please give me some advice. I am trying to be proactive in recovery but I am feeling lost and without hope whatsoever. Sorry to sound so needy and whiny I just am at the end of my road here.

    Reply

    • The ER may not be a bad place to start. If you are looking for medical detox, and there are no such facilities in your area, your local hospital may be the only option. At 55, opioid withdrawal is tougher than at 25, and you may get dehydrated more easily. You can also try the government’s website to find treatment in your area: http://findtreatment.samhsa.gov/
      and don’t forget to consider Narcotics Anonymous meetings – they won’t help you detox but can lift your spirits while you are dealing with early recovery.

      Reply

      • Posted by supershan47331@yahoo.com on September 25, 2012 at 11:29 pm

        This is so sad to me. The same doctor who is licensed to hand these out should be able and knowledgeable about how to get OFF and stay OFF these. It seems people are penalized for being honest with their Dr. I really have thought about this a lot and I truly believe the solution for the painkiller addiction absolutely has to lie with physicians….I do not know the answer, but I guarantee that is the WHERE

        Sent from my Verizon Wireless 4G LTE Smartphone

      • If the doctor were to continue prescribing, she could lose her license to practice medicine. Once a patient tells a doctor that the prescribed medication is causing harm, it’s unethical to continue to prescribe.
        However, I agree that the doctor should be able to refer (quickly) the patient for treatment, either for methadone or buprenorhpine, or for a medical detox followed by a moonth in inpatient residential drug addiction treatment.
        In medicine we have a saying…you need to know how to land the plane before takeoff. In other words, the doctor should already be prepared to treat a patient who develops addiction as a complication of the treatment of chronic pain with opioids.

  24. Hi Jeannie!! I am Shannon and recovering from an addiction to lortab that started with being prescribed them following a back injury, I was taking 30-40 pills toward the end. I had never been in trouble in my life and was charged with prescription fraud. I had the same experience with a Dr cutting me off when I told him they were a problem, which does nothing to help. I could have had my mother take them from me!!!!! I have been in recovery for 3 yrs, now, 5 yrs the first time around. My email is supershan47331@yahoo.com.Jeannie, feel free to email me I’d you would like to talk….hang in there and remember that every night you can go to bed and not taken a pill that day is a GOOD day…no matter what else happens, or goes wrong- going to bed w a clear conscience and sober mind makes that.day a success……

    Reply

  25. Dear Jeannie….I am real sorry you are facing such difficulties when all you are trying to do is ask for help. I read that you are working and well I am sure on 10 tabs a day…you will be under the weather (putting it lightly) coming cold turkey off these. I am confused why you are being answered so mildly like you have nothing to worry about but some dehydration and low spirits that NA can lift (sorry Dr. Burson no disrespect but is this all you got?) You are likely to find the E.R. Staff not to sympathetic to your 10 pill a day habit, at least I was NEVER offered any help anytime I went begging for help and I did a few times. Will work allow you a sick period of at least 5 to 6 days??? Cause this will be the least I would say you will be able to get by with. Drinking lots of water will be a good idea if you are not puking and can keep it down…..This may be the place to suggest this but since no one is offering much more there is something called the “Thomas Recipe” you can find on youtube that tells you what otc meds can assist in a “White Knuckle” opioid detox if you must go this route. I personally would try a different methadone clinic as they seem to have different protocols. I know to be considered you have to somehow prove you have been addicted to opiates for at least a year I think. I myself am shocked they of all people were not helpful because 10 pills a day if nothing to scoff at. Were they just refusing you as you went in there telling them you wanted like a 3 to 5 to 10 day detox or something????Have you researched suboxone/subutex??? Maybe this would be agreeable as I have done this in a 10 day detox twice but it was 10 or so years ago before they offered it as long term opiate replacement. It was actually the best detox I ever had. I do not do well on it for longer than that. I myself have been on MMT now for three years because for 30 years every time I get off opiates for more than six months I get right back on them because I never feel better. I believe I suffer from Endorphin Deficiency Disorder. (EDS) and I am going to be a “lifer” as far as MMT/MAT. I am not saying that is the solution for everyone as I ould try all others first but it’s better than my other options when I look at the big picture for me. Once again I would look into finding someone that might consider a short suboxone detox or even methadone detox. Maybe you need to look at more like a six month to a year MMYT to just add some added insurance. Good Luck Keep Lookin and Dr. Burson is a great place to turn maybe she felt your post was not specific or sounded not needy. I am confused.

    Reply

    • Hello all,
      I answered as I did because the poster made it clear she didn’t want maintenance treatment. At 55, she should be hospitalized to treat her withdrawal, yet she said she exhausted every known treatment center, and the center she did access didn’t make a referral. So I’m thinking she must be right, and there’s no medical detox facility. Therefore, what else is left except the hospital?
      And I do feel a little hopeless when opioid addicted patients tell me they want a fast detox off opioids, but they don’t want to feel bad, and they don’t want to have to miss work. then they refuse to consider methadone or buprenorphine maintenance. I don’t know of a workable option, thus my lackluster response.
      Jana Burson

      Reply

  26. Posted by Jeannie on September 28, 2012 at 3:59 pm

    Hello Jeannie again, Thank you all for your replies, I am getting used to hearing nothing can be done so it is ok to hear the responses. I am against maintainence for myself only as I feel detox is where I need to start. Er in this county will show you the door and tell you to see your Dr, that is definite. Not only do I work full time I am a live in caregiver and never have a moment to myself so that is why I need to maintain some sense of normalcy. The person I care for has no one whatsoever to help and I have no one to call upon to takeover for me. I have never lived in such a rural community where even going to the store is a all day event. I will say the Dr who cut me off took me by surprise as I thought he would have given me some type of option on what to do. All the closed doors has given me a stronger will to keep moving forward. I am in substance abuse counseling and will hopefully find a open door there. Thanks again.

    Reply

  27. Posted by Jeannie on September 28, 2012 at 5:16 pm

    Jeannie here, I did not want the maintanance treatment however would have considered if the clinic would have accepted me. They are the ones who said I did not meet the requirement. I am not looking for a quick fix in any sense of the word, I did not feel that asking for a detox would garner any negativity. If taking pain meds for the years I have and the amount is not enough requirement, then I do not what to say about that. Not all folks have the option of taking off work and responsibilities to go into cold turkey wd. Thanks again for the replies

    Reply

    • I’m not sure why you didn’t meet criteria, except that perhaps you didn’t have one full year of daily opioid use?

      Reply

      • Posted by Jeannie on September 29, 2012 at 4:56 am

        I was told by the counselor that going from my vicodin habit to methadone would be like a lamb to a lion, how tough it would be to come off of. I have been using for at least 3 years.

      • Methadone is tough to taper off, but you can lead a normal life once you’re at a stable dose, other than taking your dose of medication once daily. It sounds to me like you certainly did meet criteria to enter methadone maintenance.
        On the other hand, I have had patients threaten me with legal action for “getting them addicted to methadone” when the only drug they’d been addicted to prior to coming to the OTP was hydrocodone. While it’s true they were physically dependent on methadone, at least they were alive and leading a normal life – not going out to look for pills every morning.

  28. Jeannie, reading what you are going through absolutely breaks my heart! I wonder if your Dr would treat you that way had you developed a problem with any other medications he regularly prescribes patients.If so, I am glad he is not my Dr., I know most doctors do not want to deal with an addiction, but I think they should not be able to prescribe these medications to people on a regular basis if they do not want to deal with the outcome. I do not blame physicians for the current epidemic of addiction to painkillers, but to be honest in everyone that I know personally, a Dr was ALWAYS involved, maybe unknowingly, maybe 1or 2 people down the line, but in everyone’s painkiller addiction I know, 100% of the time a Dr is involved. It makes me so angry that your experience is the norm. These doctors are ok writing a prescription for #120 lortab 10/500 with 3 refills, but not ok with a patient being honest about a problem with medicine they prescribe!! I would also be angry if we were discussing insulin, blood pressure meds, or birth control. It is obvious discrimination that is applauded by people who know very little about addiction. My question is how to we stop it? Is there anywhere to make a complaint? I would love to ask your Dr how he would handle it if you were talking about any other medicine, such as an antidepressant- you aren’t supposed to just discontinue those suddenly. I would also love to tell him he should not prescribe things if he doesnt want to deal with a very common side effect….

    Reply

    • It is absolutely illegal in this country to prescribe opioids for a person who admits being an opioid addict. If the doctor prescribed opioids after the patient admitted to having a problem, the doctor would be commiting a crime. That’s been true ever since the 1914 Harrison Narcotic Act. The DATA 2000 Act that allowed Suboxone to be prescribed from an office was therefore a very big deal. It’s the first and only opioid drug that a doctor is permitted to prescribe in an office to treat opioid addiction.

      Reply

      • Posted by Jeannie on September 29, 2012 at 5:06 am

        I reread my original post and want to say I did not tell my dr that I was “addicted” what I did say was vicodin no longer worked for me and he made me write that down on a prescription pad, that was the extent of that conversation, sorry if I didn’t mention the exact conversation. My Dr is from Peru and I think he got nervous with me quite honestly, I think I was a problem for him and he was not sure what to do. He is a very nice Dr for the most part, I did overhear in the waiting room when he came out to talk to a patient that he would no longer prescribe vicodin to her, this in front of a full waiting room, that was shocking to hear, no matter what the patient problem was no one but the dr and her should have heard that. I don’t blame him for my problem it happens. I think after 3 years of daily narcotic use anyone would have a problem coming off, I just didn’t know how adverse telling the truth would be in that situation. I will get thru this.

  29. i Even if doctors would discuss expected symptoms, and ways to treat them, immodium for diarrhea and those types of things, how long severe withdrawal is expected to last, or therapists to see would be acceptable. If another med was causing problems I would not expect a Dr to keep giving a patient that med either.
    I was very blessed during my first shot at getting clean, and my Dr ( who is well respected in our community and not a pill Dr) did some things that were not law binding but very humane. He told me to meet me at his office at 1:00pm on his day off, and I told him everything, even the ugly stuff, stealing pills from my family, etc. and believe it or not, he called my sister to come back with us. My sister is an RN and he wrote a weaning schedule and prescription to me but handed them to my sister. I have no idea how it was documented, but my guess is it was written down like the 60 lortab he gave me the month prior. Some people may say this is wrong, but I do not see anything wrong. The only thing I said was I wanted to quit taking narcotic pain meds, If you read the pharmacy printout, it says if you use this medication regularly do not abruptly discontinue without consulting Dr. I have no idea if I used the word addict, but I do know I will never ever forgotten the kindness this man showed me and did not make me feel any more shame than I already did. He talked to me in the same way he would have if we were discussing any health issue. This was around 1998, and I wish all drs could be this way, even if they just wrote a prescription for immodium.

    Reply

  30. I am from Indiana, and to my knowledge, only 3 hospitals in the state even have a medical detox unit, and one of those stopped admitting people who were taking ” only opiates” because everyone thinks coming off those is not life threatening. I have always been told the withdrawals from these aren’t life threatening, but recently read of a woman going through withdrawals from vicoden in jail, she died from dehydration- from diarrhea and vomiting due to…… I was led to think I would feel bad, like the flu, 7 days and them be ok….WRONG! I had severe anxiety and anxiety attacks for six months. There is no fast fix coming off opiates. I was single coming off opiates and I had to work to provide for myself. Methadone made that possible for me. When I first started, I would take my dose and it felt like I wasn’t overwhelmed and hide a small lift in mood/motivation. That went away and I just feel normal, since I do not get the big , intense high of opiates or the horrible lows when u run out and have to chase it, I don’t have the obsession for them anymore and can function without every thought being when can I use or where can I get more pills. I have days painpills do not even cross my mind!! This is a miracle for someone who took 20-40 lortab 10/500 for 15 years. Since that is gone I do not fear being slowly weaned. I went to 12 step treatment 4 times, my only wish is that someone would have told me this was an option. I felt worse being told 12 step abstinence was the ONLY way and I continued to fail. I believe taking medication is a personal decision. I do not care about getting a token or any of that- I just wanted a LIFE! A go to work in the morning, do laundry, take out trash, sleep cause I am tired LIFE!! I finally have that and do not give a hoot what a program from 1935 thinks of it. In fact, I want to tell everyone there are medications now that they did not have in Bill w’s time and it helped me!!! If treatment centers won’t talk about options I will be glad to tell them. It seems like there are more people who fail 12 steps and feel hopeless like I did than ones who follow that way. In all honesty, I do not have any desire to sit in a room 20 years from now talking about what I did when I abused pills! That doesn’t seem like a balanced life to me at all. In my opinion, the defining characteristic of sobriety is living a balanced life. Medication gave me back the balance to get my life back!

    Reply

    • Thank you. You nicely demonstrate that no one treatment works for everyone. I too feel patients need to be told about all evidence-based treatment options.
      However, I must point out that most good 12-step meetings don’t talk about using drugs – they talk about how to lead a balanced life!

      Reply

  31. I was in NA for years and it worked off and on for me when I worked it too but I am surprised to hear anyone in MMT in support of themselves and/or their patients going to NA because it is evident from the first meeting especially in this NC area (not so much Daytona Beach FL) that NA does not welcome people on MMT/MAT.

    Reply

  32. Thank you so much for your commitment and dedication. And for your obvious passion to advocate and educate. I have recently re-entered the addiction counseling field in an effort to support and expand buprenorphine. I wish they would “loosen” the licensing guidelines so we could expand this treatment option. It seems that physicians are suspcious and intimidated by the licensing process. Are you aware of the best way to get this message to lawmakers? We desperately need more prescribers in our area
    Thank you!! You are a rare gem.

    Reply

    • Hi Nikki,
      I think education, education, education is the only way to go with lawmakers. I think some of the national doctors’ groups like American sociaety of addiction medicine and American Academy of Addiction Psychiatrists have people who lobby lawmakers, and maybe therapists and counselors could do the same.

      As doctors start to get more education about addiction and its treatment, i think doctors will be more interested in treating addiction.

      Reply

  33. There also exist this problem that once they are doctors they do not have to do too much to in the education area to keep up to date such as CEU hours are ones they can pick and choose and which to take. When I had that encounter with precipitated withdrawals and none….i mean none of the nurses and/or doctors in the emergency room even knew what this was. When I told the nurses and doctors about my dose of daily methadone they all were shocked one of them came back to my room later and said he had looked it up in some medicine administration book and he said I was lying as the maximum methadone a doctor could give me was something like 120 milligrams (I think this was pain related not MMT) but he refused to believe I took 210 milligrams of methadone daily. UNBELIEVABLE……… I had to fight them for 18 hours to help me.

    Reply

  34. Posted by James R on October 26, 2012 at 7:19 pm

    My wife has been on suboxone maintenance for the better part of her life since 2002.
    We live in a rural area in Northern Wisconsin , Where Suboxone providers are few a very far between. Her current doctor has asked her to quit smoking tobacco to remain on her maintenance,threatening to decrease dosage untIl she does , or if she dosent will be discharged when the reduced dosage gets to zero…
    At most recent consult, Dr said if we did not like treatment plan then we should find a new doctor.. of course full well knowing there are no oyher doctors within 200 miles who are accepting pati?nts…
    Is this a common practice ? What can we do?

    Reply

    • tobacco only?? Or marijuana?

      Reply

      • I wonder if her doctor thinks she may be abusing stimulants – it can be hard to tell Sudafed from illicit methamphetamine on a urine drug test without secondary testing. There are also some people who use Sudafed to excess – does your wife take more than directed by her ENT? Maybe her Suboxone doctor and her ENT should talk.

      • Posted by James R on October 31, 2012 at 8:26 pm

        The doctor has all of her medical stuff right there in her tablet. All of wife’s doctors are at the same clinic. The UA test is pretty thorough though, it lists every compound individually. The doctors reasoning is that sinus medication can become habit forming….wife has been utterly truthful about all usage, pertinent and not to her treatment…
        So where we are at now is in 3 weeks she goes back in for consult and if she has not quit smoking, then her suboxone will be further reduced…trying like hell to find another doctor b4 next consult, but all are Full-Max limit on patients… tempted to drive 275 miles to milwaukee to find her a doc.. but then i fear she will probably just opt for opiates once the drive is required…
        What can we do to get on the same page w this doctor?

  35. Posted by Nick on October 30, 2012 at 3:13 pm

    Hello I’m a 54 healthy man who’s on a 40 methadone detox program, how can I get methadone pills instead of going to the clinic on a daily basis?

    Reply

    • It’s illegal for a doctor to prescribe methadone from an office setting for the purpose of treating addiction. Any doctor with a DEA number can prescribe methadone for pain, however. For patients with addiction, often if they are prescribed a month’s worth of methadone, they aren’t able to take as prescribed, which can be fatal with methadone. Some patients who’ve been in addiction treatment with methadone and are extremely stable can manage their medications if prescribed once per month, which is why methadone patients can get a month’s take home after being stable for years.

      Reply

  36. Posted by Nick on October 30, 2012 at 3:14 pm

    Just another Q. is it totally safe or private the info given here?; thank you just respectfully asking

    Reply

    • Not sure what you mean – if you have a question or a comment that you don’t want posted, i’ll honor that but you will have to let me know. Otherwise, it’s on my blog. But I am the only person who manages my blog, sees people’s email addresses and of course I would never release those to anyone. Unless maybe if you wrote to say you were gonna harm someone. Then maybe I’d have to contact “authorities.”

      Reply

  37. Posted by Mindy on November 12, 2012 at 10:07 am

    I have a friend with three crushed discs in her back no surgery is available bc it could do more harm than good. She has been on pain meds for almost 20 years and if she runs out of her script life really goes to hell. What can she do to get relief but also get off the lortab and opana she takes? Really worried about her. She also has krones disease.

    Reply

  38. Hi
    Just saw your book. Will check it out. I am a Physiatrist in Ca in Recovery who just wrote a book about my addiction and recovery from pain/sleeping pills. It has been a long road but worth it

    Reply

  39. Posted by Kelly on November 29, 2012 at 10:56 pm

    I just found out I am pregnant and I have been addicted to hydrocodone for about 1 yr. I want to quit because I’m concerned about my baby, but I have tried several times now cold turkey and I always give in at least 24 hour into the detox because of the w/d’s. I want to talk to my doctor about it but I am scared or embarrissed really. What are my options? Is there any kind of meds the dr can give me to ease the w/d symptoms or am I just gonna have to be more determined and go cold turkey. I’m really concerned about what my addiction can do to my baby so can u give me some advice about what to do. Thanks in advance.

    Reply

  40. Posted by Aura Bailey on December 4, 2012 at 1:09 am

    Dear Dr. Burson, During a narcotic pill count, is the prescribing physician allowed to detain the remaining pills if the count is incorrect? I ask this because I have been on oxycodone for two years and recently my physician required a UDT, which came up negative for any and all drugs. Unfortunately, I had run out of my prescription too early and hadn’t taken anything for about a week when I was tested. Despite this “hiccup” my physician prescribed the same amount of oxycodone and told me to return in two weeks for a pill count. I’ve encountered the same problem – I’m short on pills because I take two extra pills per day (I wake up at night in pain and that’s when I take the pills) and now I’m very afraid of what the ramifications will be. I’ve already lost his trust because of the negative UDT. I had told him that I had taken my Rx a couple of hours before going to his office and then I got hit with the “clean” UDT, which made me out to be a dishonest person (I was being dishonest). When I return to his office for the pill count and I don’t have enough, I’m afraid he’ll detain my remaining pills. I just don’t know what to do. I have legitimate reasons for my prescription, I just need two more than he’s willing to give …and it’s created quite an anxiety ridden situation for me. Thank you very much for your time and consideration of my problem. I really do appreciate your input!

    Reply

  41. Posted by tesha on December 16, 2012 at 5:48 pm

    Hi My name is Tesha, i Have been addicted to roxicodone for 6 Years now i have finally decided that im done,i dont want this kind of life anymore but i dont know what to do, the last roxy i had was last monday the 10th, i dont have any kind of sub except for i had 1 1/2 methadone wafer and ive been trying to take as little as possible everyday but it now almost gone, i guess i just need support because im very weak and i cant do this alone im really trying but its so hard my biggest weakness is getting pill sick, im so scared i dont do well with being pill sick and i dont wanna end up taking another pill i just need to know what to do? how do i control this sickness? i dont have AA or NA to go to im just by myself please help me get thru this, ill be waiting on your answer thank you so much for making this website also, Thanks again

    Reply

    • Posted by tesha on December 16, 2012 at 6:08 pm

      im sorry but please get back to me soon just because i dont know what to do and dont want to do another pill… thanks

      Reply

    • Hello Tesha, and thanks for writing. The disease of addiction is too much for most people to handle on their own, so I recommend getting an evaluation at a treatment center to see which type of treatment is most appropriate, and also available in your area. this website is a great place to start looking: http://findtreatment.samhsa.gov/
      I’m not sure what you mean about NA/AA – are there no meetings in your area, or are you saying you don’t want to go by yourself? You can try calling an NA or AA hotline if one is listed in your phone book – you can ask them questions and this may help you feel more comfortable.

      Reply

      • Posted by tesha on December 19, 2012 at 10:01 am

        yes you are correct i dont have a AA or NA in my area, I havent had any medication in 3 days since i weaned myself off the methadone however i do have the craving but i do keep trying to tell myself i dont want it ive done too good to turn back now but the thought is still there and i hate it, how can i get this out of my head? i found a suboxone doctor but i have no insurance and they are not cheap, so therefore i dont have anywhere to get an evaluation.

      • I’m sorry to hear that. Lack of money prevents many people in the U.S. from being able to access healthcare. If you send me your zip code I’d be willing to do some looking for you.
        Have you looked into online recovery meetings? I’m not too familiar with the sites but I think you could google for them.

  42. http://atwatchdog.lefora.com/2012/12/15/never-has-happened-in-13-years/?vm=14#post14

    Come register at this site we are a methadone treatment forum…you can talk to quite a few like you….in your registration be sure to say in a message you are the person from this site.

    Reply

  43. I need help, my husband had his fingers crushed at the knuckles and they were able to save and fix them. But this happened years ago, his hand works although his fingers are limited. He works in the oil field and says he had a cracked disk n his back but X-ray doesby show it. I don’t deny his pain but he completely abuses his meds. He has a script a month and breakthrough meds as Well, this is first month due to our marriage almost ending that he hasn’t had to buy more on the street. He completely denies it….as he nodds off, we have cigarette Burns on everything!! I know he needs them, I think, but I also know addiction because I’m a recovering addict. What do I do? He pays for his Dr visit before bills or his parole!! He tells himself he can’t work without them but takes them everyday and only works two days at most a week. I’ve griped, threatened, talked… two years ago he didn’t need them like this, he says he just didn’t complain but I know he is exaggerated it, he hurts but Geez my mom has ruptured disks and doesn’t take hers unless she can’t handle it. He says but she doesn’t work……he barely does either, hasn’t n almost two weeks and still takes them…….please help, I might need to just get divorced.

    Reply

    • I’m so sorry but I can’t give advice with such a complicated problem. This blog is for general information about opioid addiction and treatment, and you and your husband need to see a addiction specialist, in person, to get the kind of help you need. Even if he won’t get help, make sure you do. His doctor can’t give you any information unless your husband has signed a release, but you can give the doctor information. If she’s smart, she will do something to see if he’s misusing pills, like pill counts, random UDS.
      Please also consider going to some 12-step meetings. Alanon or naranon are for friends and families of alcoholics and addicts, and you can get some good ideas and information there.

      Reply

  44. Posted by ktibbs on January 5, 2013 at 7:08 pm

    Hello Doctor,

    What a pleasure this is. What an amazing way to reach out to people to actually help! And you do this in your own time? Unheard of in today’s world – what a blessing you are! I would like to thank you so very much for your work! A true positive testimony to the well-being of humanity! I just can’t believe my eyes and my heart-senses! Thank you.

    May I ask a question, please? I have been taking prescribed meds since 2009. My dosage started at 60mg per day of Norco. I am now prescribed 90mg per day – (2) 20mg of oxi and (3) 15mg of roxi. However, my tolerance to the substance is way beyond what I am prescribed – I have broght this up to my pain management doctor and they made a slight adjustment, but nothing too drastic. Anyway, I take 200-240mg per day, as that is what is needed with my current pain levels and I always cut myself short – every single month, by a minimum of two-weeks. Which leaves me buying friend’s supply to get me through the month, aka, the “pill-chase” (at not such an affordable price).

    My question is two-fold; I think I may seek treatment using Suboxone. I do consider myself an addict, because my body/mind has become dependent upon the daily use of them. However, I do feel that if I was prescribed what I actually need, I wouldn’t have to purchase through friends and the stigma would be so much less on me. I know this all depends on my doctor’s decision, but if I was to seek counsel from him, telling him that I run short every month and have been for the past 6 months, is he likely to “label” me an addict or actually prescribe me what is needed? I want so badly to be able to tell him, but I just am really concerned of being labeled, thrown on the board, and rejected further service. I have been a loyal and “quiet” patient of his for over a year. Additionally, if I do decide to quit and turn to Suboxone for a trial perid to see if my pain levels are manageable as I ween myself down, is that strictly confidential between the Suboxone doctor and my pain management doctor? I am not going to doctor shop – I would love to be able to just tell my PM doc that this is my plan, and if it doesn’t work, may I come back? With all these laws in place, I feel trapped. And I really don’t feel like I should feel this way. If the sub goes well, I would contact my PM within this month and notify him. I guess in general, what is the privacy policy?

    Thank you so much, doctor. I truly appreciate your advice. Many Blessings

    Reply

    • When treating addiction and/or mental illness, doctors and other care providers have to adhere to a standard of confidentiality that’s even more stringent that HIPPA. We can’t even say if a patient is in treatment with us unless we have a signed consent from the patient. However, your doctors may not be willing to treat you unless they are able to talk to the other doctors involved with your care. In other words, I think the Suboxone doctor you see will want to be able to contact your pain medicine doctor. And yes, if you tell your pain management doctor you are misusing your medication, she may decide it’s not appropriate to continue to prescribe opioids for you.

      Deciding if a patient has developed tolerance, common to many pain management patients, or true addiction depends on psychological symptoms as well. If you use medications in ways not intended (e.g. snort pills) or use illicit drugs or alcohol to intensify effects, or use pain pills to treat bad moods, or obsess about taking pills, running out, getting more…those sort of things determine whether you have true addiction or a pain management condition that needs a higher dose of medication. Plus, are you functioning better on this higher dose of pain medicine than you did at the 60mg? Or is your daily functioning the same…or worse?

      I advise you tell your doctor the whole truth. Clearly, what you are doing now isn’t working, and something must change.
      thanks for reading

      Reply

      • Posted by ktibbs on January 6, 2013 at 4:53 pm

        Hi Doctor, Many thanks for responding so prompt – I am very thankful for this dialogue.

        To answer your question regarding daily functioning, I actually do feel that I function better when I take the higher doses – I am clearer, as I am not in so much pain and my energy level seems to stablize – this is probably just due to the fact the my tolerance has risen.

        My biggest concern is what seems to be a developing liver issue – which has been getting worse over the last six-months. I have had testing done on my liver and everything has come back normal. However, I can feel it swelling and I have lost so much energy – very heavy fatigue which has now turned to lower functionality. I want to switch over to the Suboxone so I can monitior and cleanup my liver. I do not drink alcohol, or involve myself with any other type of drugs. I actually take very good care of my body, from lessons learned – I eat well, stay on a balanced vegetarian diet, and practice yoga. This way of living is my new-normal for the past 4 years. However, this wasn’t always the case – I am 35 years old now, and I used to be very hard on my body, believing that I was invisible in my late teens and throughout my twenties, which has brought on numerous bouts of pain-stricken ailments – nerver damage, 4 blown discs, 1 of them almost completely gone, muscle spasms, and bad arthritis.

        I want to be open and honest. I do not wish to keep any secrets. I have had the same PCP for over 8 years (I don’t doctor shop). I just do not want to be labeled and refused pain medicine down the road should I decide that life without the pain medicine help has become too difficult. I am an honest man, a business owner, a father of three, and a husband of 15 years. You are correct, what is happening now is clearly not working and only making matters worse – I will be doing the right thing and keeping everyone in the loop.

        I sincerely thank you for your valuable input. I will be doing the right thing.

        I hope everyone on this blog finds their light at the end of the tunnel that they are looking down – it is there, just have to walk a little farther to get to it. This doctor has done a beautiful work with this blog, which I hope everyone is so thankful for. Many blessings, everyone.

      • Unfortunately, buprenorphine (Suboxone) can cause liver inflammation, unlike most other opioids (unless they are in a combo pill with acetaminophen). but it sounds like this is your self-diagnosis and your labs were OK. It’s something to talk about with your doctor, though.

  45. Posted by kylr on January 5, 2013 at 9:15 pm

    I have been on methadone for 11yrs. From the street….is there anyway i can get on a real methadone prog.. I can inpatient. I really just want help and stability in my life so I can keep working and go to college but not have to worry about being sick… I’m not just trying to get drugs from the government I just want stability in my life for right now.. please help anyway you can. Ty

    Reply

  46. Posted by jenny on February 7, 2013 at 11:41 am

    Hi. I have been on MMT for 3 years. My current dose is 42mg which was working. All of a sudden i feel very anxious and nausea. They asked me over phone if i wanted to go up. I don’t know if i should. I’m on 5mg ambien, 25 mg seroquel, .5 mg of klonipin, and 30 mg of Prozac.. All ate taken only once a day. I take Prozac in morning, klonipin at 3 pm and the seroquel and ambien at night for sleep. 42 is the highest I’ve been so I’m scared to go up. I’m no small person I’m about 300 pounds and female. I told them i only want to go up 2mg call me paranoid I’m ocd. I am scared to go up. What do you think?

    Reply

    • I think you should see your doctor at your opioid treatment program, so she can ask you some more specific questions. There are many things that can cause anxiety and nausea besides opioid withdrawal, and your doctor can help you sort it out. I always make sure the patient isn’t pregnant, for example. Also, could your other medications be causing problems? If you read my blog you know I’m no fan of ambien and klonipin with methdadone, both because of the dangers of the combinations, but also because benzos have few indications for use past three months. But without knowing your medical history, all I can say is see your OTP doctor and voice your concerns. You may want to see her before you dose one day, so she can assess withdrawal signs during your lowest methadone blood level.

      Reply

      • Posted by jenny on February 11, 2013 at 11:17 am

        I know I’m not pregnant. My benzo hasn’t showed in my last 6 urines. I just got an increase of 2mg. They said my eyes were dilated and they took my blood pressure and stuff etc. they suggested 5 but i did 2. I want to get off the seroquel so i can get take homes. I also want to get off the Klonopin but last time i tried i got real sick. I thank you for your response. I have been on methadone for over 3 years.

  47. Dear Doctor Burson,
    Please first understand that I am a desparate woman that went on methadone for the wrong reason. I’d been in a really bad car accident on 10/07/11 and then again less than 3 months later, on 12/31/11! Both were caused by mechanical (and other) failure issues. I was lucky to escape with my life and after the most recent crash, was diagnosed with 4 ruptured cervical discs, 1 ruptured and one torn, thorasic disc, 3 herniated, 2 bulging and torn lumbar discs and several pinced nerves, torn tendons and muscles in both arms, although more severe on the right. I went to the emergency room only when I was able to get out of bed on my own and get a ride there, using my own insurance. That was a few days after the 75 mile crash, head on into a culvert.I did refused at the accident scene, as I was in shock and didn’t think I was injured enough to go to an emergency room, I was wrong. When I did though, I’d recently been on suboxone treatment for long term opiate addiction after seeing a spine and sport’s medicine doctor for many years after I had a bad fall at work and was injured in a car accident when I was rear ended in 2002. In 2009, I knew I still had pain but knew I was addicted and struggled till 2011 at which time I went with a friend to a church, where the pastor there was a suboxone doctor. I was able to detox from oxycodone with the suboxone but at least 50% of the time I took it (in small doses, like 2-4mg twice a day at most.)I would have terrible migraines and throwing up. It made me so ill. So, after the most recent accident, the emergency room wouldn’t give me anything for pain because Suboxone was on my recent pharmacy profile. They referred me to a ortho clinic that took several weeks to get an appt. The doctor there did MRIs, made a very nice report with friendly letter attached about how he would be willing to help me in any way he could and see me at any time. The truth was, he said he could NOT help me and referred me to a Neurologist for a nerve conduction study only. The Neurologist had to give me the results as he was going to send the results to this Dr. that had made no return appt for me and referred me to physical therapy as well. The Physical Therapist looked at the test results and did a quick exam. He said there was nothing he could do for me. with torn muscles and tendons in my arms, they needed to heal. He said I could come back to see him in a year. I haven’t yet. He referred me to massage therapy. He also told me that I could get pain relief from methadone and told me where the nearest “treatment center” was. Now, a year later, I’m worse than I was the day I saw the doctor. I cannot tell what is happening in my body really. I feel terrible all the time from the methdone and I need to know what is the quickest way to detox this drug, that stores in fat and muscle, out of my body? Please help me. No one will give me pain medication, which is what I need along with surgury. I can barely use my right arm. It’s filled with knots, scar tissue and calcium deposits. When I touch the tendons in my upper are, it send radiating, shocking pain down my arm to my fingertips.I have not be able to find a doctor in the area that cares about my health, at all. I know they are out there, but I’m having terrible luck finding a personable, caring, compassionate doctor. Many doctors, while I’m in the middle of telling them what my complaints are,, will interrupt me with a comeback of how sick they are. My old psychiatrist was the worst at that, but he wasnt’ the only one.
    If you can give me some advice, on how to get off methadone without suboxone, I would be oh so grateful.

    Reply

  48. Yes, I realize my case is very complex and I’m 46 years old and in bad health, but I think my best option would be to find a Suboxone doctor and make an appointment if I can find one that accepts my insurance, I’ve been researching for months, and just recently, we have had a couple of doctors in the city that are precribing Suboxone and if I can deal with sickness for a few days I should be able to start Suboxone(even though is my last ditch effort) and not stay on it for an extended period of time. I do very much appreciate your taking the time to read my comments(letters) and reply. I know MMT is the best for some people but it has caused way too many health problems, including insomnia and the inability to wake in the morning because of horrible withdrawal symptoms.

    Reply

  49. Oh, I do want off methadone without Suboxone, but the only way I can do that is if I have a substancial amount of money to get into a treatment center that specializes in methadone detoxification. Unfortunately, their methods haven’t been practiced for a very long time, but it’s much safer than the rapid detox method, which I can’t afford either. None of them accept insurance, so I don’t have many options. If I can find a sub dr that takes my insurance, I had some bad reactions to suboxone, but I think after a year on methadone, I could probably handle it, I just don’t want to stay on a suboxone maintanance program, I’d rather use Kratom capsules, but I’m on much to high of a dose, dropping to 92mg, tomorrow. Don’t have a clue how long it will take to get an appt but there are several docs in the area that are licensed to precribed suboxone. I remember less than two years ago, there were none. Your advice and opinions are appreciated.

    Reply

  50. Before i got in my accident, there were only a couple of doctors in this city that presribed Suboxone and neither accepted insurance. I was living in a city about 50 miles away, which put me a lot closer to another larger city. I was told about a very inexpensive Suboxone doctor that was also a paster and I saw him until my first of the two major car accidents. That was why no doctor was willing to prescribe me pain medication, even after two major car crashes…because Suboxone was on my pharmacy profile. In fact, the doctor that performed my MRI suggested MMT and stated he could not help me. I’m in the process of applying for disability and have an appt with their doctor this week. I feel that my biggest mistake in life has been being poor. No matter what the reason, people judge you differently when you don’t have nice clothes to wear, make up, jewelry, etc. Everything went to my children and grandchildren but I feel guilty that my disabilties have made it impossible to do what I once did. Methadone hasn’t helped one bit. I wake up sick, sick, every single morning, sweating and feeling the flu like symptoms which make it so very difficult to even get out of bed to make it to the clinic for noon!! Goodnight, and bless you.

    Reply

  51. Posted by Lisa on February 18, 2013 at 12:39 pm

    My 55 divorced sister in law is addicted to pain killers, methadone and other drugs. She has been in jail several times for “hit and run” car wrecks. She has alienated her only 25 yr old daughter and lost her job 2 weeks ago.
    I am married to her only sibling – we do not know where to turn. She cooked thanksgiving- falling asleep every few minutes while cooking- eating in front of our family. Please advise us- do not know what to do! Thank you

    Reply

    • Living with a person in active addiction is too much for most people. Thank God there are more resources now than ever before for the families afflicted by addiction. Treatment centers have family groups and family days, and many therapists are skilled at helping family members. There are 12-step groups devoted to helping family and friends of alcoholics (Alanon) and addiction (Naranon) in nearly every area of the country. Alanon does make a distinction between alcohol and other drugs, while Naranon is for families of people addicted to any drug including alcohol. However, in practice, many people attending Alanon do so because their loved ones use drugs in addition to alcohol.

      Popularized by the TV show “Intervention,” some families hold these interventions for the addicted family member. An intervention usually contains certain elements: the addicted person’s friends and family gather together in the presence of the addict, they tell the addict how much they love him or her, they tell the addict how much their addiction hurts them, and what they want the addict to do about his/her problem. Usually this means going to an addiction treatment center. Families usually also tell the addict there will be definite consequences for non-compliance with their requests.

      What if the addict won’t go to treatment? Unless you live in a state where you can involuntarily commit someone because of addiction, there’s not much you can do.

      Some people deal with addiction in less directive ways. For example, in Alanon, the focus is kept not on the addict, but on the distressed family member or friend who is affected by the addiction. Alanon helps people deal with the dilemmas that appear with addiction, whether the addict is in or out of the home. Some people go to Alanon years after the addict is dead, because of the long-lasting emotional effects addiction can have. More about Alanon’s approach to dealing with the distress of addiction can be found at their website: http://www.al-anon.alateen.org Alateen is not for alcoholic teens, but for teenagers who have been affected by the alcoholism of a parent or other close relative, or friend.

      Reply

  52. Posted by Ross on June 3, 2013 at 7:39 pm

    I am 28 years old and been suffering from a 25-30 pill a day addiction. I’m so tired of chasing being sick an not being able to be the proper father I wanna be due to my lack of having parents. I been to methadone clinics an did well on 110mg dose once per day. No cravings an not a single use for the three monrhs I was there. The closest clinic is almost two hours away an I had to go seven days a week. With my wife an I being young parents to two wounderful children an her working full time as well as me taking care of our family farming operation I could no longer afford to drive that every day. I live in a small town in southeast Tennessee where a lot of people go to doctors just to get medicine they really don’t need. I’m in desperate need of advice on how to get a local MD to prescribe me the methadone I need so I can have my normal life an the family I’m able to be a father an husband for when I’m not using dilaudid! Please I’m willing to listen to any an all advice I can get about how to solve this horrible issue.

    Reply

    • Hello Ross,
      It’s illegal for a doctor to prescribe methadone in an office setting to treat opioid addiction; that can only be done at opioid treatment programs which are heavily regulated by state and federal governments. In your area, there’s not a nearby opioid treatment program in TN, as you know. There may be programs closer to you in either Virginia or NC.
      Have you looked into the option of suboxone? That medication can be prescribed through a doctor’s office, once the doctor gets a special license to prescribe, and SE TN has some suboxone practices.
      Other treatment options are inpatient detox followed by a month or more of inpatient residential treatment. In your area it seems hard to access, at least for the period of time you need. With opioid addiction, a few weeks of treatment isn’t likely to work. It’s more costly, and you’d need to miss that time off work. Often that’s not a workable option.
      If I were you I’d investigate suboxone options. you can go to suboxone.com or to http://buprenorphine.samhsa.gov to find a doc

      Reply

  53. Posted by jessica on June 27, 2013 at 10:50 am

    hi my name is jessica and i currently attend a methadone treatment center located in knoxville tn.. my question was that is it true that if you are on a stable dose and having no positive drug screens for years that at that point with referral from the methadone clinic that an addiction expert can then take over and give you a rx of methadone? it seems like i read that a few different places..

    Reply

  54. Posted by John Doe on July 19, 2013 at 2:24 pm

    Thank you doctor. You answered some of my questions. I am pretty sure I am going to need a root canal and kicked oxycodone and oxycontin cold turkey after over two years of daily use. I did not know if I could ever take pain killers again and I have a swollen jaw and a massive toothache. I was scared to take anything again as I never want to go through that withdrawal again. Was horrible. By the way, I don’t advise anybody do what I did. Cold turkey is brutal and some of the symptoms lasted 4 months.

    Reply

  55. Posted by lisa.treadaway4708@yahoo.com on August 24, 2013 at 3:15 pm

    Hi , my son is 26 and bn on soboxon for several years. He has a op addiction. He has found very good work $24 dollars an hr. but he now travels from state to state and is gone 3 months and then is back home for a week. Every doctor he sees after searching the world over will not take him again when he come back home after bn at work for three months. I know my son is not the only one in the world that takes this med and works out of state and travels. We live n Birmingham Alabama. Just wondering if u had any help on the subject. Thank you.

    Reply

    • Hello and thanks for the comment.
      I don’t know of any doctor who would write for three months of suboxone at a time for a new patient. It’s not good medical practice. A new patient needs more care than he can get just coming to a doctor’s office four times per year; I would insist on some sort of counseling. I usually see my new patients every two weeks and eventually every month if they are doing very well. However, I have a few patients, in recovery for years and who have gone through good counseling, who I see every two months.
      Work is important. But there may be things that are even more important, like getting good care for his opioid addiction.

      Reply

  56. Posted by Charles Holly on November 18, 2013 at 8:38 am

    I I am trying to understand why I could take subutex sometimes and sometimes I can’t take subutex subutex works very well for me and I would like to get back treated with subutex to stop using opiates what can I do for me not to go to full withdrawal after taking subutex

    Reply

    • Since buprenorphine, the active ingredient in Suboxone/subutex, is a partial opioid, if you aren’t in at least moderate withdrawal before you take the first dose, it can cause you to go into withdrawal. I suggest you enroll in a treatment program to let a doctor help you.

      Reply

  57. Posted by Melvin Lee on December 2, 2013 at 6:20 pm

    Can my doctors force me to see a psychiatrist and to get in a drug program in oder to receive pain medication for the serious injuries I have?

    Reply

    • No one can force you to see a doctor or get in a drug program if you don’t want to do so. But then, the doctor may not be willing to prescribe medication for you, unless you do.

      Reply

  58. Posted by nullc0re on December 10, 2013 at 8:16 am

    I’ve been reading this discussion about whether NA/AA groups should “allow” MMT/suboxone patients to share/discuss their recovery experience. Their official stance is counterproductive. MMT and suboxone are legitimate methods of recovery. Many countries have government sponsored or subsidized MMT/suboxone clinics.

    Look, it’s like this:

    An addict in active addiction could die any day. Methadone has saved the lives of many, many people. I truly, truly wish someone in NA would have suggested MMT to me years ago. It would have given me those years back.

    The NA folks discouraged me from even considering MMT, when they could clearly see me struggling. I was dying, and “one day at a time” wasn’t cutting it. I tried MMT to fulfill a probation requirement that I be in some sort of treatment program, and it instantly turned my life around.

    I now own a house. I’m going to law school next year. And yes, I’m still very, very, very bitter, angry and resentful at NA and my 12-Step-bsaed IOP group for actively discouraging this life-saving medication.

    Reply

  59. Why don’t you do this first instead of blogging go get to a methadone clinic and get on methadone for 3 years and get all of a methadone detox your body within let’s say eight days and see how you feel for the next month to begin feeling like a person again then go to your suboxone doctor and get suboxone to last year for a month at a time for 5 years and then try quitting suboxone within ob the say a month we’ll see how what kind of withdrawals you go through the same anybody else would go through you would much rather die and I’ve heard nurses taking care of babies that the mother would be better off if she had been addicted to heroin for the babies withdrawal would have been only a day instead of a full month

    Reply

    • Well, no, you’re wrong.
      If the pregnant woman didn’t get on suboxone or methadone, it’s much more likely the nurse would be caring for a very premature baby in the ICU with multiple complications. or that the baby would have died before being born.
      This comment drives home the importance of telling patients that methadone and buprenorphine are not meant to be quick fixes. They are best if used indefinitely, for maintainence.
      If a patient wants to be completely opioid-free from the beginning, don’t use methadone or bupe. They are opioids and they do have withdrawal, though addicts can feel and function normally while on them.

      Reply

  60. Posted by Rachel on December 15, 2013 at 9:45 pm

    Hi Dr. Burson,

    I wanted to say thank you for the hard work you do in the field of addiction medicine. I’ve been on suboxone since it became legal to prescribe in the US.

    I’m only able to find one page here of people’s experiences (and found them very helpful) and am wondering if you have anymore pages like this one on your blog? Would you be willing to post a link if there’s more?

    Thank you,
    Rachel

    Reply

    • Yes there are – look back at around the end of May of 2013, and I have an interview with a buprenorphine patient. But that’s the only patient interview. there are many comments throughout my blog from patients on buprenorphine; I don’t have the tach saavy to be able to tell you how to find them specifically.

      Reply

  61. Posted by rex hartley on January 18, 2014 at 3:22 pm

    Just found this blog..looking forward to reading much more.3 years clean with the help of subs.

    Reply

  62. Posted by Raec on January 21, 2014 at 7:33 pm

    Everyone should check out this new website. Prescriptionsanonymous.org

    Cindy Mogil is also the Founder and author of “Swallowing a Bitter Pill”. She use to have a website 10 years ago but has recently decided to update her website and help through online consultations! Prescriptions Anonymous

    Reply

  63. Posted by kaila on January 24, 2014 at 6:09 am

    I need help I use to take pain.pills to get high then I worked up a tolerance so I started on subutex which I wish I never did I didnt know ud withdraw off of them so I tried to get off them cold turkey and I got to day five I couldnt do it forst few days werwnt bad but 4 n 5 were horriable I started subs again I only take a quarter a day I heard about these natural pills for detox n witjdraw callrf wothdraw ease they help I wanted to try and I’m on depression n anxiety meds I dont want to withdraw thats why I take the sub idk what to do

    Reply

  64. Hi,

    Thank you for your nice writing on how to Cure addiction and I was reading it and I think my time is not wasted

    Thanks

    Reply

  65. Posted by Joni on February 10, 2014 at 4:09 am

    I find your blog very helpful. It helps me realize I’m not the only one. My question is, do you think an opiate addicted person should stay on Suboxone indefinitely or maybe the rest of my life or do you practice reduction off Suboxone until I am totally off? I have heard so many different things from different sources it drives me crazy. My Dr’s belief is a patient needs to eventually get off suboxone. I do not feel comfortable with that choice at all. I’m so afraid I will eventually go back to using prescription pain pills again. I’m so tired of Drs and government people who don’t know about addiction who think they have the right to decide what is good for me. Please tell me what your thoughts are on eventually stopping suboxone. Thank you for letting me vent.

    Reply

    • The studies show best results are seen in patients who stay on buprenorphine (Suboxone). But every person is different, with different history and preferences. If one of my patients is doing well on buprenorphine and wants to stay on it, I fully support that. Opioid addiction is potentially fatal. People die in relapse, so the decision to taper off shouldn’t be made lightly. Most people would prefer to be off all meds but it isn’t always possible.

      Reply

  66. Posted by beth feinsilver cohen on February 12, 2014 at 10:02 pm

    To the poster who has a problem with NA/XA Meetings, this is one of my persona l problems with them too!! I could have avoided so many years and of painful, emotional & financial troubles, had I just started medication . These people were adamant that no one who takes the medication ever succeeds , and that they are doomed to live in abject addiction all their miserable lives!! All the “happy joyous and free” and white knuckling it all the way , not being able to relax or be comfortable and finding it difficult to just think !! Cravings that occupy your every thought , asleep and awake!! I do not know why it is so easy for them to ignore the 50+ years of research done by major universities , medical schools and published in established journals and publications. Makes no sense for them to ignore such vital and important information that mean life or death for those they counsel. Treatment has made such a positive difference in my life . Addiction is not something cured in a few years , if ever!! We do have chioices and for those of you that have found success in XA I am so glad for you as I know it does help some , I just wish for me someone would have said “it is time for you to try different treatments”!! But in the end , I hold my self responsible you really do have to investigate every option available to you, if something is not working try to find a treatment that will.

    Reply

  67. Hi Dr. Burson,
    Remember me? I’ve been away from writing for quite a while, but recently been toying with getting back to it. Either way, June 13 will be 2 years I’ve been opiate free. One of the things I find so amazing now is how much anger no longer rules my life. I do think I needed it to get through methadone detox though. Don’t worry, I’m still just as opinionated as ever, but I feel it’s in a more toned down, rational manner. Anyway, just wanted to say hello and that I’ve been checking up on you. :) Glad your clinic is doing well as I have always felt you stand for what is best in a doctor-the patient.

    Reply

  68. Jana I’m new here and wanted to message you but can’t figure out how so I just hit the first “reply” button I seen… I am a addict here is a bit of my addiction past..
    at age 22 (now 31) I became so sick I hurt all over all the time couldn’t eat all I wanted to do was sleep had headaches everyday no energy at all just not myself I was working as a phlebotomist in a dr’s office with 3 providers 2 md’s and a PA. Not feeling good or like myself I started seeing the PA told him all my symptoms and him being a total quack and dirty old man would tell me I just needed to go home and “get a good piece of ass” then he would write me whatever pain pill he felt like writing that month… me hurting all over I would take the medication knowing I had a additive gene because my mother was also a addict it never crossed my mind to be careful instead I started feeling some what better got use to being “numb” started loving it! It was a awesome was to deal with life to deal with a bad marriage to deal with my mother dying to deal with any problem big or small in a years time I was hooked… Finally knowing myself I was hooked but no one else knowing …yet..
    I decided it was time to see the Dr not the PA anymore come to find out I had been bit by a tick and had had RMSF The whole time for over a year! Had the PA done something besides be a ass I may have had a chance to go down a different path but anyway it happened and I pay every for it… I have been on subutex for 2 years now I’m doing ok but lately I have started hurting and aching all over again I wanna see a Dr but how do i convince them I don’t want a pain pill I just wanna find out why I’m hurting so bad again??

    Reply

    • I don’t know any better way than the way you just explained it – you’re doing OK on subutex but have pain and don’t want a pain pill, but rather would like a diagnosis.

      Reply

      • I guess I’m afraid they will tell me its not real pain because they say when you become addicted that your body no longer knows what “real” pain is but I know the difference subutex takes care of what I call phantom pain this is real achy bone joint pain one Dr told me after being dx with RMSF that since it stayed in my body for so long without treatment that I would always have flare ups and that my joints could have damage as well what are your thoughts about that?

      • I don’t feel I can answer that one on a blog – too many variables. All I can recommend is keep talking to your doctors.

  69. Posted by Cynthia on April 13, 2014 at 11:47 pm

    I have been off pain pills over a year. I am still on 4mg suboxin film a day. No matter how hard i try icannot seem to taper any lower. i still feel like my life is a mess. My house is always dirty,I’m a crappy mother,i never have any energy.life just sucks now.i feel like pain pills ruined what ever chance at a happy life i ever had. My question is how long after quiting pain pills does it take to be normal again? Do i have to quit the suboxin for what i am looking for? I think back to the times before pain pills and my life was pretty good. Used to do lots of thing’s with the kids,managed to cook dinner 5 night’s a week and keep my house somewhat clean. Now I’m lucky if i cook once in two weeks.i feel like my kids are loosing out on a good life. The only good thing is i am finally financially ok after paying off all the title loans,payday loans pawn shops and ect from my former addiction. Any advise would be great.

    Reply

    • the short answer to your question, which I think is, “Will I ever feel OK off all opioids, including Suboxone?” is… we don’t know.
      Many patients who have used opioids for a period of time feel lousy for a very long time after stopping them, with the fatigue you describe. Some patients feel a little depressed, irritable, and achy all the time. We call this post-acute withdrawal. It’s not as bad as full withdrawal, but it’s draining.
      Why do some people feel this and others don’t? How long will it last? there’s no way to know at present. Clearly, it can last weeks to months, and it’s very hard to get through that without relapsing back to opioid use. is it related to the amount of opioid used, the length of time you used opioids, or some other factor, like genetics? All I can tell you is there’s much research going on about this now.

      We don’t yet know how long is the ideal time to be on suboxone. some patients decide they want to stay on it indefinitely, since they feel so much better while on it. Opioid addicts probably need a year or two on suboxone to give them time to make life changes and address other issues, both mental and physical.
      For now, if you feel bad on 4mg, I’d consider increasing the dose to see if you feel better on a higher dose. Yes, that will mean you’re on opioids (Suboxone) longer, but unless there’s a reason you must be off suboxone soon, why allow more time to get counseling, see a doctor to make sure there’s no other physical health issues going on, and continue to make progress financially? And for sure, talk to your Suboxone doctor since he/she knows your history. Explain to him/her how you feel.

      Reply

  70. Posted by Susan Strauss on April 25, 2014 at 7:17 pm

    I attempted to inject subutex but missed the vain. It started as a rash but now looks more like purple streaks on top of light purple rash area. I don’t have health insurance but if this is going to kill me I’ll take the bill. It burns like fire is on my skin. Please help.

    Reply

  71. Posted by AnnaJ on May 2, 2014 at 12:15 am

    I’m hoping you might be able to give me some advice, as I’m in a bad situation, but unsure as to how to proceed without making it worse. My story is unique enough I don’t want to go into details even online… but in a (very small) nutshell, I am a chronic pain patient, tho currently with no doc/treatment (ACA/Medicaid transition screwups, yay), but I am able to have the prescriptions that I need to keep functioning in the meantime written, and pay a small fortune for them out of pocket. Which doesn’t include my extended release pain medication as it’s way too expensive, so doing my best with just the breakthrough pain med. Which was ok tho not great, as by now I’m rather used to being in pain all the time and know even with the extended release med, I’d still be in some kind of pain.

    Problem is, my boyfriend is an addict and also has mental health issues including depression, finally got him into treatment last year, but visits are few and far between. Meanwhile, he’s no longer taking his prescribed meds on a regular basis – but he is taking mine. Technically he “asks”, in actuality there is no question he’ll get them, he’s got a variety of “reasons” I guess so he can pretend he’s not manipulating me and/or what he’s doing isn’t completely 100% wrong…. yes, I should have walked away a long time ago, but I didn’t, so that kind of advice isn’t helpful – I’m too sick and broke and in a new place where I hardly know anyone – so just picking up and leaving is not an option.

    I want to go to the same mental health facility (free) and he even encourages me to, as obviously I’m extremely depressed now – well, that’s more my reason, he thinks they’ll get me on Medicaid, etc. like they did him – and, of course, he tells me to “omit some of the truth” – as in, not tell them he is taking my medications. Obviously, he doesn’t want to loose “the best of both worlds.”

    I know I need to do something about this, for numerous reasons… I can’t keep living in so much constant pain with barely any relief, and going through withdrawals every month… first just one week a month, but he’s working his way up, this month it’ll be 1/3rd of my pain med prescription… and it’s certainly not helping him any. But I’m terrified if I tell the people at the clinic, I could end up loosing my right to be prescribed pain meds – and with chronic and incurable health issues, that’s not an option I care to entertain. I’ve looked through their privacy rights info and it’s still unclear… I don’t know if legally they have to tell “the authorities” what’s going on? I don’t need to end up being labelled an addict (if my pills were counted now by someone obviously I’d be way short) or as if I’m selling them?! I am at my wits end… I have never abused my meds, gotten early refills, etc., even without being able to afford the extended release med., etc., etc. – but now, along with all the other issues his addictions and mental health issues have caused, I have to worry that I’m the one that could end up in trouble or denied pain meds – while he’s being patted on the head and told they’ll get him help (sorry, I know that sounds really snide, so I do want to make it clear that I believe addiction is a disease and that his issues are just as serious as mine – part of why I’ve stuck with him and encouraged him, especially when he makes progress with treatment and kept us both with a roof over our head for so long)… when his job is done until fall in a few weeks he promises he’ll go for suboxene treatment, but can’t now ’cause there are too many meetings, etc. he would have to attend and he works too much for that… but I’m pretty sure once his job end there will just be another excuse, there always has been.

    How do I let the mental health people or someone know what’s going on without risking my own right to pain medications? Or am I worrying about something I shouldn’t? I can’t find answers anywhere online, it’s an impossible situation to google… and I’m just about at the end of my rope.

    Thank you for reading at least and I hope this makes some sense, pain is also scrambling my brain more than my health issues already do…

    Reply

    • The best solution is simple: don’t allow another person to take medication prescribed for you. It’s illegal, and as you noted, making his situation worse. You know he has a problem with addiction, so why are you giving him fuel for the fire?? What if he overdoses on medications you gave him? In some states you would be criminally charged, besides which you would of course feel awful.
      Nothing good will come from giving away your medication. If you can’t or won’t stop giving it away, you shouldn’t be prescribed this type of medication. That may sound harsh, but it’s the only other solution.

      Reply

  72. Posted by Shannon on May 18, 2014 at 7:11 am

    I have a pretty great question that I’d like to just Bluntly Ask.. The Story behind the question is very lengthy and basically, Neither Here Nor ThereThere to be honest. .
    On each Suboxon Strip, there is a Code on the back. Is that code linked to the person whom it was prescibed to?
    And if so, Is there anyway the public can access that program as well?
    For instance, My young neice has been buying them from someone who gets them prescribed to them. She absolutely will not any type of information about who is selling them to her BUTTT the other day, I found the (whatever you call the thing that the strip comes in) and noticed that code thing onthe back. I don’t Want to take this to the authority’s due to my nieces involvement. However I want to know once in for all who she is getting them from so I can then alert maybe the clinic that distributes them of the patients wrongful doing with it. Idk exactly what i would do at this point but i just have to find out who this person is. Any help?

    Reply

    • Yes, the code on the Suboxone film package is linked with a pharmacy and a patient. No, the public can’t access this; it’s protected health information.
      I can’t think of anything you can do except talk to your neice and let her know how worried you are about her, and maybe offer to take her to get treatment in a safe, legal way that will also include counseling.
      Police probably have the authority to track down black market Suboxone but you would have to go to the authorities to report this.

      Reply

  73. Posted by Jules on May 25, 2014 at 4:46 pm

    GUYS – i got off 6 MSIR30’s daily and 8 Norco/Lortab’s, prescription for scoliosis, several herniated discs, after taking the for 20 years (gradual build-up to that level) –
    like this: i used KRATOM from a quality vendor (first order was just lawn clippings, i think, but second batch was quality!). If cannabis is legal where you live, use the indica – the saliva just makes you feel crazy, so i hear.
    FIRST, I got off the Norco/Lortab, since it’s SOO mentally addictive. Kratom really helped with the depression that goes from those evil pills! After that, i just had to deal with the pain from going off the morphine pills.
    It took about 2 months (with a break from rehab’ing from the Norco) to get off everything. I am now relatively pain free WITHOUT pain pills.
    Those pills can & frequently do cause ‘hyperalgesia’. They literally make your body have more pain!
    It’s worth it – i really DO feel fine now without pain pills.
    There IS life after pain pills.
    Best part? I’m not attached by the nose to a nosey, distant, aloof, uncaring pain management doctor who takes about eleven – two week vacations a year, and is never there for you.
    Just think: you could take the money you spend on pain pills and fly or drive to CO, and stay wherever you have to, to get off these drugs. But if you can’t do that, I’m TELLING YOU, the Kratom-does-work-for-pain-and-depression-while-getting-off-those-drugs!
    Yes, in case you were wondering, there IS A GOD.

    Reply

  74. Posted by Virginia Hall on May 27, 2014 at 2:38 am

    I have been on Suboxone for about two months now. As of a week ago my hands and arms are going numb and are hurting as well. In addition my feet and lower legs are swollen too. Do I need to find another treatment to stop my opiate use or will this side effect go away in time?

    Reply

    • I’m not sure. That’s not a common side effect of suboxone, though I’ve had methadone patients report swelling, and I know methadone causes some people to retain sodium which results in swelling. I think you should talk to your doctor.

      Reply

  75. Posted by Daff on May 29, 2014 at 2:45 pm

    I wish I had access to your blog in 1998 when I started the methadone clinic. Your blog is informative and just really good reading. Thanks for sharing.

    Reply

  76. Thank you for helping me to understand this law on hydrocodone better.I’ve been on this medication for several years. How can a doctor prescribe this medicine for so many years to a patient and you go back for youre next months appt. And without notice he has closed his office and want open his door and you can’t even get you’re medical records in anyway. What law protects you from that.Where do you turn because you can’t even think and the pain physically is so overwhelming it becomes a mental issue.

    Reply

  77. Posted by Lynn on June 24, 2014 at 5:28 pm

    My 24 yr old son is a chronic relapser – he continues to fall, but gets back up and is now trying again. He has Hep C and often complains of fatigue – he lives in Florida and I in MD. Is it dangerous to his health for him to try the vivitrol shot ? He can’t seem to get past 3 months :(

    Reply

    • I depends on how bad his liver is – his doctor should be able to tell you. If he has damage from Hep C it could be too risky…but then again…so is opioid addiction.
      Many people relapse often in recovery, especially early on. Has he already tried methadone and/or buprenorphine?

      Reply

  78. He is adamant against using methadone. He has used suboxone in the past but easily misused it (of course this was years ago when he wasn’t as serious about his recovery). He has been off and on for approximately 7 years and has been in Florida for the last 4 – presently he is in a halfway with IOP and a sponsor and as usual he thinks he can do it this time. Maybe he can but his recurrent relapses always occur around 3 months of sobriety and he has 5 weeks. I have been advised by his sponsor to stay out of and not discuss his sobriety. Probably a good idea?

    Reply

  79. Posted by Johnb46 on July 15, 2014 at 8:49 pm

    A big thank you for your article.Thanks Again. Great. aaffedcdddcd

    Reply

  80. If you seek treatment for pain pill addiction are you covered under the HIPPA privacy act. Will your employer be notified?

    Reply

  81. Posted by Kim K on July 30, 2014 at 10:08 pm

    Hello
    I’m a 40 yr old single mom of a 17 yr old girl and was diagnosed with MS in 2007. I’ve never had flare ups til this year. My mother pretty much all of my life has been a pain pill addict. From codeine to lortab to methadone to norco and more. I was a cheerleader thru HS and she never once came toy games. It was my passion. I remb her sleeping. She’s been to prob over 5 rehabs. We’ve done the family counciling. We def have had our share of family trauma. Who hasn’t. She absolutely thinks she is not an addict. That she has serious pain. She takes 90 Norco, 90 Valium, 120 muscle relaxers and more. She’s has had seizers for years and years from encephalitis and her addiction. My daughter has watched this like I did growing up. She was a good grandma when she quit for a while. I have an older brother that won’t help. Everyone has turned their back on her but me. My daughter will not have anything to do with her anymore. I don’t know what to do for this addict that I’ve grown so cold towards. I feel like I abandoned her but yet she doesn’t think she needs help. I feel like I’ve tried everything and now suffering with my MS from the tremendous stress. Do I just cut her off? If I do she’s completely alone.. She gets messed up and falls and blacks her face. Been thru so many hospital visits. Had a horrible retal prolapse? Her rectum was so stretched from being constipated from pills they had to remove 2 1/2 feet . So many seizures. So angry. I just don’t know what to do

    Reply

    • You eloquently express the suffering families of addicts experience. I don’t think anyone can tell you if it’s right to cut your mom off or not…please get some counseling help for yourself to help you make the best decision. Also, consider Alanon as a way to talk to other people going through the same thing, or Naranon.

      Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 411 other followers

%d bloggers like this: