Author: TeeJay
Posted: Thu Feb 28, 2013 8:42 am
Interesting ideas. I can’t say if they (the medical world) have any solid idea about long term effects of an increase in tolerance. I have a personal belief based on what I’ve experienced from being on Sub, heroin and methadone over 12 or 13 years.
Using full agonists I’ve found only makes your tolerance go UP over time. That’s true for methadone as well. With full agonists, dose creep (needing more and more to get the same effect) is more noticeable than with buprenorphine. Over my using career my tolerance gradually climbed and climbed. If I went back on Suboxone I found each time I needed more to hold my cravings.
Sub was interesting because I went on it really early in my using when I was 18 or 19. I’d been using heroin maybe once every 3-5 days, and I went on Sub because I thought it’d keep me high 24/7. I went on 4mg at first and I was loaded – I was really nicely stoned so much so the doctor dropped me to 2mg. I was a bit stoned on 2mg but I eventually got used to it.
Getting off Sub was pretty straight forward, but the withdrawals from jumping off 1mg were stronger than any withdrawals I experienced from heroin. What was interesting though wasn’t the withdrawals or the PAWs … was that my cravings were actually stronger in the months after I got off Sub than they were before I got on Sub.
I really do think that any increase in overall tolerance in a persons using career can result in them experiencing more intense cravings once they stop. And it can take many months, even years for those cravings to subside. So for me, that first time on Subutex definitely increased my overall dependence on opioids, and it would probably have been better for me to just try and stop using than go the drug-replacement route. Then again I just wanted to feel high all the time, so you get what you pay for I guess.