Author: TeeJay

Posted: Tue Mar 05, 2013 5:30 am

I agree with Will that Suboxone is a form of harm minimisation. Any form of recovery is harm reduction. Abstinence is the best harm reduction, and in terms of your health / long term prognosis, Suboxone is just as good. A person who steps out of addiction and onto opioid-replacement therapy like methadone or Suboxone has a much better chance at living a long, happy and fulfilling life than someone who attempts abstinence. That’s a statistical fact.

The reason that drug-replacement is an acceptable treatment for opioid addicts is because opioid addiction is by far the most difficult addiction to recover from. Without drug-replacement, relapse rates are upward of 94% within 3-6 months of getting clean. That’s more than cocaine, meth, cigarettes, alcohol. Then there’s the funerals. Life expectancy of the opioid addict is 15-20 years from when they started using opioids. That’s pretty grim.

The smarties in the medical world realised that these addicts lives could be literally saved by being provided long acting opioids with less abuse potential in a clinical setting. Methadone was the first drug used, as well as LAAM and later buprenorphine. The long term outlook for people on methadone/Suboxone improves markedly compared to those who attempt recovery without it. Total abstinence = 94+% chance of relapse. Methadone and Suboxone is around 30% – and even those who do continue to use do so with much less intensity, and find their quality of life improves significantly.

Don’t be sold any wrong ideas about it. Suboxone is an opioid. Methadone & Suboxone fall under the banner of Opioid Replacement Therapy / ORT. It really is a drug-for-a-drug, no bones about it. But the main difference is that methadone and Suboxone are long acting opioids with slow onset, and are taken at a regular dose each day. Opioids by their nature stop getting you high if you continue to take the same dose and the same amount each day. The only thing that sets bupe apart is that once you get to about 8mg, taking more doesn’t have more effect, so patients can be more trusted to dose themselves than methadone where your dosing is monitored.

Choosing between opioid-replacement therapy and total-abstinence is a trade-off. Choose total abstinence, and you’re getting at most a 1/20 chance at long-term recovery, but if you do succeed your quality of life will be arguably better. Choose methaonde/Suboxone, and you’ll have a much better chance at achieving recovery, but your quality of life may be slightly less (as you need to pay for doctors, take medication each day, and may experience some side-effects).

It’s really your decision to make, and it’s a really huge decision in terms of your life. I personally chose Suboxone after I’d attempted total-abstinence more times than I can count, and only managed to get 13 months clean, and a few months here and there. And I was sick of relapsing. I often encourage people to try total-abstinence at least once before turning to maintenance. Why go on ORT if you’re capable of living without opioids completely? You can always go on Sub later if you fall over. Just don’t die trying!!

Author: TeeJay

Posted: Tue Mar 05, 2013 5:30 am

I agree with Will that Suboxone is a form of harm minimisation. Any form of recovery is harm reduction. Abstinence is the best harm reduction, and in terms of your health / long term prognosis, Suboxone is just as good. A person who steps out of addiction and onto opioid-replacement therapy like methadone or Suboxone has a much better chance at living a long, happy and fulfilling life than someone who attempts abstinence. That’s a statistical fact.

The reason that drug-replacement is an acceptable treatment for opioid addicts is because opioid addiction is by far the most difficult addiction to recover from. Without drug-replacement, relapse rates are upward of 94% within 3-6 months of getting clean. That’s more than cocaine, meth, cigarettes, alcohol. Then there’s the funerals. Life expectancy of the opioid addict is 15-20 years from when they started using opioids. That’s pretty grim.

The smarties in the medical world realised that these addicts lives could be literally saved by being provided long acting opioids with less abuse potential in a clinical setting. Methadone was the first drug used, as well as LAAM and later buprenorphine. The long term outlook for people on methadone/Suboxone improves markedly compared to those who attempt recovery without it. Total abstinence = 94+% chance of relapse. Methadone and Suboxone is around 30% – and even those who do continue to use do so with much less intensity, and find their quality of life improves significantly.

Don’t be sold any wrong ideas about it. Suboxone is an opioid. Methadone & Suboxone fall under the banner of Opioid Replacement Therapy / ORT. It really is a drug-for-a-drug, no bones about it. But the main difference is that methadone and Suboxone are long acting opioids with slow onset, and are taken at a regular dose each day. Opioids by their nature stop getting you high if you continue to take the same dose and the same amount each day. The only thing that sets bupe apart is that once you get to about 8mg, taking more doesn’t have more effect, so patients can be more trusted to dose themselves than methadone where your dosing is monitored.

Choosing between opioid-replacement therapy and total-abstinence is a trade-off. Choose total abstinence, and you’re getting at most a 1/20 chance at long-term recovery, but if you do succeed your quality of life will be arguably better. Choose methaonde/Suboxone, and you’ll have a much better chance at achieving recovery, but your quality of life may be slightly less (as you need to pay for doctors, take medication each day, and may experience some side-effects).

It’s really your decision to make, and it’s a really huge decision in terms of your life. I personally chose Suboxone after I’d attempted total-abstinence more times than I can count, and only managed to get 13 months clean, and a few months here and there. And I was sick of relapsing. I often encourage people to try total-abstinence at least once before turning to maintenance. Why go on ORT if you’re capable of living without opioids completely? You can always go on Sub later if you fall over. Just don’t die trying!!