Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Suboxone: Amazing Detox Tool, Monster Maintenance Drug.

An Expert Talks About Suboxone: Dr. Steven Scanlan of Palm Beach Outpatient Detox

Steven Scanlan M.D.

Steven Scanlan M.D., medical director of Palm Beach Outpatient Detox

Steven Scanlan, M.D. is board-certified in psychiatry and addiction medicine. In his practice, Palm Beach Outpatient Detox (PBOD), on the Florida coast, he has detoxed more than a thousand patients off many drugs, including alcohol, benzodiazepines (Valium, Xanax, etc.), and sleep aids. But his specialty is opiate detox.

Scanlan has been practicing as medical director of PBOD for about two years. His practice, he said, is located in an area where more than two-thirds of all oxycodone prescriptions in the nation are issued—the south Florida coast that has become notorious for its “pill mills.”

Scanlan said 70 percent of his patients come to him addicted to oxycodone at levels of about 300 to 600mg per day. About 20 percent also come in with alcohol problems. “The rest use Vicodin and Ultram,” and a few come in addicted to Fentanyl, he said.

And then there are the increasing numbers who come to him desperate to get off Suboxonea drug that combines buprenorphine, a synthetic partial-agonist opioid, with another drug to prevent abuse. Suboxone (commonly known as “Sub” by people with addiction) is used in opiate detox and maintenance, it’s known and “prison-heroin,” and it’s now commonly sold on the street.

Scanlan says he has seen Suboxone work brilliantly as a detox tool and dangerously as a maintenance drug.

I first heard Scanlan speak on a podcast that’s now defunct. Two reasons I was eager to talk to him:

1. Scanlan chose addiction medicine as a result of his own recovery from opiate addiction. He understands addiction from personal and professional experience. While training to become an anesthesiologist Scanlan became addicted to Fentanyl, a strong opioid used in surgical procedures and for severe pain. After trying many times to quit on his own, he found a physician who helped him detox over two weeks using Subutex—plain buprenorphine—and other medications to ease the detox symptoms. He joined a recovery program, then decided he was well equipped to help others suffering from the same problem. Many of his physician colleagues didn’t like working with addicted patients, but he found he did. In his practice, he doesn’t just dole out drugs; he gives patients 24/7 followup until they’re physically comfortable and involved in some kind of support program.

2. I wanted to hear his clear-cut ideas about detoxing off opiates. He only does detox. He never does maintenance. Unlike so many other scientists, who believe people addicted to opioids can never stay off them, he believes we can get free.

“Believe me—it’s much more lucrative to do maintenance, to keep patients on Suboxone,” he said, adding that it’s even more profitable than, for example, doing Botox injections. Hundreds of practitioners—some of them with no experience with addiction—prescribe Suboxone as a maintenance drug, keeping patients on it for years at high levels and charging exorbitant cash fees. But for the vast majority of addicted people, Scanlan does not believe drug-maintenance is appropriate—or even safe. Buprenorphine is such a new drug, he says, and its long-term effects have not been adequately observed and researched.

He has said that Suboxone may curb cravings for other opiates and allow people to stop stealing and get their lives in order. But the problem is that, after three months or so, patients have terrible difficulties quitting Suboxone because of its sheer strength in binding to opiate receptors, its long half-life, and the fact that it’s a partial-agonist binding to receptors built for full agonists. And despite what the media tell us, there are many people who don’t want to spend a lifetime on high doses of Suboxone.

You know what? When I was detoxing off fentanyl in 2008, I felt so good on Suboxone that I thought about staying on it. Then something happened. I no longer felt so good. My feelings dulled. I no longer wanted food or sex. I realized my body was adapting to the drug—or trying to. Fortunately my outpatient detox doctor had no more slots for Suboxone maintenance patients, so I tapered off as quickly as I could. If my doctor had been operating under the new Comprehensive Addiction and Recovery Act, he may have had a slot for me, and I might have gotten trapped on Suboxone as so many others have.

Scanlan said most people, including physicians, do not comprehend the strength and effects of buprenorphine. “Everything changes in the body when you’re on opiates long-term—the way the body regulates pain, the way it regulates hormone production, sleep, emotions—everything,” he said. And buprenorphine, he repeats, is an opiate. Its effects are not just physical: as a psychiatrist, Scanlan has noticed in his practice that at long-term doses of just 2mg, Suboxone can block almost all of a person’s emotions.

In addition, buprenorphine’s half-life is 37 hours, which means it takes the body more than a day to excrete half the dose. When dosed once a day, the body doesn’t have time to catch up, so the drug builds up in the system—a phenomenon called “bioaccumulation” that Rachel Carson documented in the buildup of toxins among wildlife in her book Silent Spring. A patient dosing with buprenorphine at 8mg is not only getting 8mg—he’s getting the 8mg, plus the amount not yet metabolized from the day before (4mg). And 8mg is a low-end maintenance dose. In the U.S., patients are commonly dosed at 16mg or 24mg per day.

“There’s definitely a risk to going on Suboxone long-term—anything over three months,” he said. “It would be easier to detox patients if they were coming in at a year’s time at one milligram, or a half-milligram, which is where they should be. But they’re always coming in at 16 milligrams. Or 4 milligrams for four years but really they’ve been at 8 milligrams and they’ve lowered it just before they’ve come to see me. I have to get them to tell me what they’ve REALLY been taking.”

Scanlan is the only professional I’ve ever heard who can explain why the body reacts so differently to Suboxone than to full-agonist drugs like heroin, Vicodin and methadone. Read on…

Suboxone tablets

Suboxone 8mg tablets

G: Educate me about buprenorphine.

Scanlan: It’s the most amazing detox medication I’ve ever seen. But for maintenance—it’s harder to get off than methadone. Suboxone is 25-45 times as potent as morphine. It’s the king of the hill in terms of opiates—it displaces every other opiate off the receptors, except for Fentanyl. [Maintenance physicians] use way too much of it. When you build up to a serum level, it’s SO POTENT.

Americans should look at European countries’ use of buprenorphine. They’ve had it much longer than we have. They use lower doses; they have as much maintenance as we do. In Scandinavia, what do you think the number-one most-abused drug is?—buprenorphine. Simple facts: they’ve had it longer, and it’s the most abused drug. That’s what I’d like people to know about.

Buprenorphine is now the 41st most prescribed drug in the U.S. Five years ago, it was the 196th most prescribed. [Update, April 2016: Suboxone is now the 16th most prescribed drug in the U.S.] So you can see what a money machine it’s becoming. … The research to get Suboxone approved [by the FDA] was funded in conjunction with the NIH. Until the NIH is run by someone in recovery from addiction, this propaganda will continue. [National Institute on Drug Abuse Director] Nora Volkow is great, she’s smart, I’ve met her, but she doesn’t have a clue.

G: Why don’t you prescribe Suboxone as a maintenance drug?

S: I wasn’t against maintenance when I detoxed. But I’ve seen a lot since then. And I had a detox physician who told me, “Do NOT stay on this drug for more than three weeks, or else you’ll be dealing with a whole different problem.”

Buprenorphine is a partial-agonist opiate. It binds to the receptor and only activates it partway. Opiates are meant to bind to the receptors and activate them fully. But if you put something completely foreign in the body like a partial agonist, the body says, “What is this?” and it tries to reach homeostasis. It struggles to understand it as a full agonist, and it can’t. There is nothing in nature that is a partial agonist, and our opiate receptors are not designed to operate with partial-agonists. Buprenorphine definitely does something unnatural to the body.

I’m not against maintenance for a certain percentage of the population. I have a friend who runs a methadone clinic, and I think there’s a percentage of patients who need to be on maintenance for the rest of their lives. Perhaps five percent of the [addicted] population. If you want to do maintenance, though, you want to do methadone. Methadone at least has been used for a lot longer, and we understand it better.

G: How do you conduct detox?

S: To detox patients off long-term Suboxone, I use clonidine [a blood-pressure medication] and Librium [a benzodiazepine] because it’s more water-soluble. And I use Darvon, a weak opiate. Its half-life is short. … The Librium is the last to go. And they complain of disturbed sleep. I don’t use Seroquel because it can be abused. I use what acts on the antihistamine and melatonin receptors—the only two receptors they haven’t messed up yet. … It can take five months to get someone off long-term Suboxone.

For a Fentanyl detox, I give them Subutex. Fentanyl detox is the most brutal detox but it has the quickest recovery of the receptors because Fentanyl has such a short half-life.

I tell them to exercise. Studies show that 12 minutes of exercise per day with a heart rate of greater than 120 beats per minute restores the natural endorphin system in half the time. The people who do that, their sleep architecture returns to normal in half the time of people who don’t exercise. Twelve minutes. And of course you can do more.

G: And you urge them to join a recovery program?

S: They need some kind of support system. Let me tell you—everyone who’s stayed off Suboxone, they’ve been in AA or NA. Thirty-day inpatient programs have an average rate of 5 percent sober after one year. But from what I’ve seen in my practice, anyone who does an honest fifth step in AA or NA stays sober—the numbers are greater than 50 percent. And anyone who can do an honest ninth step and make amends, the number shoots up to over 90 percent.

Everyone who comes to me, I get them off opiates. One-quarter of the people I treat are sober at six months, and ninety percent of those are actively involved in some program. They’re not just going to meetings or involved in community service—they’re actively seeking some kind of spiritual growth. It all comes down to whether people want to do the work.

G: What about people who are afraid of becoming depressed after detoxing from long-term use?

I ask them, Was there ever a time you were sober? Did you have a bout of depression before then? If not, then it’s probably substance-induced. You have to take a thorough history. The statistics say: of all people who get clean, 15 percent have mental illness. Maybe a bit higher than the general population.

This site has always been free. If this post helped you, please like and share.

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Related posts:

How To Detox From OxyContin and Other Opiates

Reader Questions: Addiction, Chronic Pain, and Drug Maintenance

Have questions, or want to see someone interviewed here? Email me at guinevere (at) guineveregetssober (dot) com.

46 Comments

  1. This is an amazing post! Especially the point that 12 minutes of exercise/day will fix our endorphins! I’m going to make sure I focus on getting at least that.

  2. Very interesting – thanks for this.

  3. It would have been helpful if Dr. Scanlan had addressed those opiate addicts that became that way after dealing with chronic pain. If there is no long-term maintenance, how will they stay off of opiates? Maybe a different way to address that is how will they get pain relief? “Buprenorphine is now the 41st prescribed drug in the US.” Where is OxyContin, Fentanyl and morphine? Most opiate addicts became that way because of being prescribed pain medication for legitimate chronic painful conditions. Are they included the 5% of addicts that may need maintenance? Or are we just discussing the ‘recreational’ users?

  4. Ibogaine works for opiate withdrawals. It is illegal in U.S. and there is no money in it, so big pharm won’t touch it. It is a little more difficult with suboxone but is done. Complete reset of opiate receptors to a pre-addictive state. No withdrawals and no cravings. Very humane way to detox. After-care is still an important factor, changing patterns and lifestyle triggers.
    Suboxone is some nasty stuff.

  5. guinevere

    April 12, 2011 at 11:18 am

    @Dora… I have a friend who had a positive experience with Ibogaine. If anyone is curious about it I can refer you to some resources. … Thanks for your input.

  6. Well, I’ve been on both and I disagree. Perhaps you shouldn’t be giving people 24 mg’s a day and it won’t be so hard ! I was on 8 mg and it was too strong. There have to be other contributing factors to the statistics, like they are still doing other drugs, or their dose is just too high. Don’t you now people are raising their doses so they can get high ? And please don’t say you can’t get high on Suboxone, because you can. Perhaps it’s the doctors and not the drug ???

  7. Carolyne Shapiro

    August 12, 2011 at 1:14 am

    Wow! So so glad I found this site! Amazing.
    I have been on Subutex x 1 year. I did not go on it to withdraw from opiates however, though i am in recovery x 14 years. I went on due to post chemo effects lasting well past what they should have and could not function until Subutex. When i say could not function I mean weak, mood swings, pre-mature menopause, crying jags, hot flashes and could not get out of bed due to severe weakness. It was horrible. Suboxone was awful for me but not so with Subutex. Hving had cancer (breast and cervical (2003-2007) I was a mess. The Subutex I take daily and believe me, i tried everything prior. it has given me my life back. This post though sacres me a bit now though. Cheno and Prednisone no joj=ke – they are the most mind altering drugs i have yet to ingest and trust me – I tried just about all of the opiates and then some!!!!
    If i have to be on it the rest f my life i will. It sure beats being in a Fentabyl coma or heroin coma or any opiate come anyday – those were my drugs of choice. Long story. The chemo really screwed me up in ways I never knew imaginable. So, i don’t know. i have the utmost of respec for what it is you write and i love your site. if you get to my reply perhaps you can shed some light on my situation for me.
    Warmly,
    Carolyne Shapiro
    Sherman oaks,
    California
    This post/blog is so great ih ave referred everyone i know just about and I thank you so for starting it!!!!

  8. What a great interview! I am printing this to give to my doctor.

  9. This is a great interview and everything … but MY EXPERIENCE suggests there’s a bit of fear mongering on this guy’s part about Sub maintenance & it’s withdrawal effects (although the point of ‘it’s not well studied’ is a good one).

    I have two experiences kicking off of Subutex. I admit I almost never ‘dissolved’ it, I always insufflated my dose, I firmly believe makes it slightly stronger … most importantly, it’s done in 2 seconds, instead of 20 minutes of holding gross spit in your mouth. I will share each w/you here:

    Time 1: @40 years old. After 3+ years of abusing OC at around 240mg/day (as well as adderall/ritalyn/speed during the last year … in descending order of preference), I moved away from my old neighborhood, away from connections, and weaned off Subs over 7 months in isolation. Dose was roughly 16mg/day (months 1-2), 12mg/day(months 2-5), 4mg/day (month 6) and 2mg/day for the last couple of weeks. This was imminently manageable myself except the last drop to 2mg, which I had to have someone distribute to me daily.

    At that point, my Mom came and got me, and I detoxed at her house under her watchful eye. I basically went with NO RX’d comfort meds until day 6, when I cracked (after three nights no sleep) and called my sub doc, and he gave me clonidine, neurontin, and ambien. Honestly, days 3-6 were pretty god-awful, but really not much worse than OC detox after 24 hours (the longest I’d gone w/o opioids in prior 3+ years).

    Once I slept on night 6 thanks to those meds, on day 7 the clouds parted, and I felt about 80% normal, and the only lingering problem was back pain and fatigue, and insomnia, which lasted a whole month. After about 10 days (so about day 16 overall) I stopped the Ambien and switched to Unisom until day 30. Then quit the sleep aids, and slept well afterward.

    Time 2: @44 y.o. I was 100% clean and sober through NA/AA for 3 years, then started thinking I could drink again once in a while … which led me back to Subs after about 8 months. Hungover, I found an old stash of Subs, and I was off and running, called my old Sub doc as soon as those ran out. I spent 8 months on them, abusing them for a buzz at first, but never getting above 4mg/day.

    The last 3 months on Subs, I never was on >1mg/day, and weaned the last month down to around .4mg/day (a 2 mg pill divided 5 ways). I also had Clonidine, Neurotin, and Ambien from day one. This time the w/d effects were a cake-walk compared to kicking off 2mg/day.

    I’m at 2 weeks clean now, never missed a night of sleep (thanks Ambien!) … the only effects are, again, fatigue, lack of focus/motivation, and a sore friggin back (low endorphins I’m sure). But I’m getting better each day. I’m in AA/NA meetings (GREAT advice, Doc :)) and got a sponsor, gonna start the Steps soon.

    Bottom-line, the 5 months thing … that’s gotta be a MAX. If you just get your Sub dose nice and low, it is HONESTLY not that bad a w/d. It just lingers a bit.

  10. I love this article and hope many people will feel the same way. This article is about everything I have been researching and wanted to prove. This medication is no joke and just allows addcits to continue additcion for year on end. This is the number one over abused drug in like the uk or canda or somewhere. We are allowing people to continue addiction becuase it is legal this is a disgrace and something should be done about it.

  11. id love some knolage and to get ibogaine,,,going to try to kick sub ,,,,on for six months 8.2 ,,,,3times a day ,,,,,now im regreeting it Craige ..
    craige60@gmail.com…any help would be greatl for a start

  12. Thank you for the information about this. I am an addict (and new blogger) of many substances. I got off opiates with methadone, but that was in the stone ages.
    I always wondered why my new program friend, counting days, looked effed up as hell every time I met her.
    Now I know.

    I look forward to reading more!

  13. Thank you for this story, and the website as a whole. There is some great stuff on here and I’m enjoying the in site and stories as well. I was just wondering whether you have an idea of the dosage/taper for this doctor and his patients. I am onto suboxone tomorrow and my doc has no idea really. He’d keep me on it as long as I want. So no more than 3 weeks. I have a 8 day taper planned. I’ll see how I go. Thanks again!

  14. Glad you were able to find help with this interview. I’m not a physician, and I daresay that Dr. Scanlan’s taper protocol with Suboxone varies depending on the drug(s) his patient was taking, how much, how long, etc. You can get direct feedback from others detoxing at Opiate Detox Recovery (http://www.heroin-detox.com). The forum has a buprenorphine detox section that’s very active. … Thanks for reading and please check back to let us know how it goes.

  15. iam the guy that needs to be on its so bad right now that iam buying it off the streets i was on it for 4 years and got off of it 4 a year and a bit but never felt normal at all i hate it soooooo much some times i want to kill myself but i havbe 2 kids and a good wife but just cant be happy cuz iam worryed about getting them thats all i think about i wish i could just have 2 mg every 2 3 days thats how i take it i would rather or came off of heron

  16. ibogaine does not work for sub detox, been there, tried it and failed, the PAWS are too long from sub for anything to work. You have to be clean from suboxone for 6-8 months to stand any chance of feeling a placebook let alone decent..The sub damages the receptors too much, and nothing on this Earth can fix receptors, its like saying bring back someone a live who has died, its impossible for receptors to be fixed.. I know believe me.

  17. I am an addict really really bad. Been on suboxone for two years between 8 and 14mg per day. My doctor is out of town for two weeks and I am out of suboxone and the clinic will not refill it until he returns, bt then I will be fully dt’ed and not need the dr. I am really scared about the withdrawels coming. I want my life back and suboxone has not helped long term. I am scared. I have nobody in my life and I am all alone.

  18. Kevin, are you abusing your Suboxone—is this why you’ve run out? How is it going for you today?

  19. I just think that I went on due to post chemo effects lasting well past what they should
    have and could not function until Subutex. When i say could not
    function I mean weak, mood swings, pre-mature menopause, crying jags,
    hot flashes and could not get out of bed due to severe weakness. It was
    horrible. Suboxone was awful for me but not so with Subutex. Hving had
    cancer (breast and cervical (2003-2007) I was a mess. The Subutex I
    take daily and believe me, i tried everything prior. it has given me my
    life back. This post though sacres me a bit now though. Cheno and
    Prednisone no joj=ke – they are the most mind altering drugs i have yet
    to ingest and trust me – I tried just about all of the opiates and then
    some

  20. Hyperbaric oxygen is very expensive, but it does help stop the PAWS & nightmarish withdrawals & the brain & nerve damage. I have a portable hyperbaric chamber with two oxygen concentrators to get the same amount of 02 they use with HBOT clinics. Iboga & hyperbaric oxygen do stop the paws if used together. And when they have been off the suboxone for 14 days naltrexone helps reset the receptors. There are a few rehabs that use hyperbaric oxygen & iboga. One if called the Holistic sanctuary. There is a place in Miami that uses HBOT, colonics, sauna, vitamis & herbs. Then there is a place in England called Castle Craige that uses hyperbaric oxygen that is really cheap compared to other rehabs. It cost like 60 a day plus $40 to live there, so a month would be less than $3,000.

  21. Derrick.. I completely understand what u r goin thru.. I have a child myself and I’m a single mother.. And I cannot find anywhere that will do an inpatient detox unless I have insurance which I don’t.ive even thought of trying to tell drs tht I’m am gonna commit suicide just so they will keep me somewhere for a month or 2

  22. Thank you for the site you posted. I haven’t checked it out yet but I def am going to!

  23. Subs suck just quit sub come down is longer

  24. Vicky Ledford Jenkins

    August 11, 2013 at 2:50 pm

    How easy is it to get the sub? Is it expensive? I think I know someone that may be doing it 🙁 Is there another drug that they call Sub? I hope!!

  25. Thank you SOO very much for this interview! The information that I have obtained, is of such great significance… It is truly TERRIFYING to think that Buprenorphine is harder to get off of than Methadone. It’s exactly the information that I needed to know, which concludes my decision on “long-term maintenance” using Subs.

    Thanks,
    Seth

  26. I don’t think there’s any other drug people call “sub.” It’s becoming easier to get on the street, and as far as I know an 8mg tab/film goes for about $20.

  27. Vicky Ledford Jenkins

    August 15, 2013 at 9:08 pm

    Thank you, also do you know what Spur is or what it stands for? What it does to you? I have heard this also when the conversation of drugs are happening anything you can tell me would be helpful so I know what I am up against a VERY worried and concerned Mom 🙁

  28. Vicky, no idea what Spur means. … For worried and concerned family members, Al-Anon is a great place to start. /G

  29. Vicky Ledford Jenkins

    August 16, 2013 at 6:50 pm

    Ok thank you anyway 🙂

  30. Melvin D Morris

    August 23, 2013 at 2:05 pm

    I need help I cut myself back with the subs the last I used was a quater of a strip and that was four days ago when will I start to feel better what should I do to help with the detox anything would help please

  31. My understanding is that there is quite a bit of variation from person to person as far as the intensity of sub withdrawal. For myself, it was an unholy experience. The worst 25 days of my life. Anxiety, insomnia, and depression linger way after. I wouldn’t take Subs if you held a gun to my head. Ten days of short acting opiate withdrawal feel like a massage compared to Sub withdrawal.

  32. NA is proven to have dismal rates of success. In fact there are studies that show people in NA are more likely to use than people recovering on their own. The fact that this guy is spouting NA as the way to beat addiction throws all his credibility out the window. That said a huge portion of heroin addicts do indeed need suboxone for life. A larger portion than this man admits. I’d venture that a lot of his patients relapse very quickly after he detoxes them and sends them to NA!

  33. Wow! Where do you live? 8mg of sub (film or stop sign) goes for at most $10. Most sell them for $8.

  34. Fascinating that you think you know more about Dr. Scanlan’s practice than he does.
    Please cite your studies. It would be interesting to look at sample size, methodology and duration.

  35. Why don’t you prove me wrong? Please cute your studies. It would be interesting to look at sample size, methodology and duration. Look up,”the orange papers”. That’s one study. I find it fascinating that you think it’s so fascinating that I could possibly disagree with this doctor. I’d love to see your numerous studies backing up how well NA works. I’ll wait here patiently.

  36. I never claimed NA works. Read the piece. … What I’m claiming in my reply above is that this physician knows his practice and his patient-base better than you do, which is just truth.

    The Orange Papers do not constitute “proof” of anything. They are, according to the author, “One Man’s Analysis of Alcoholics Anonymous and Substance Misuse Recovery Programs.” As such, they’re opinion.

  37. Yes they are one man’s opinion, but he cites many studies and facts within it. You were extremely condescending towards me and I found it strange because you have no idea what I know, what my experiences are or what my educational level is. To come off the way you did seemed oddly defensive. NA doesn’t work for many, many people. Suboxone does work and it’s saved countless lives. I’m sorry that you don’t understand why I think he’s wrong. But I agree to disagree with you. (I’m on my phone and its auto correcting so my grammar and spelling is atrocious.)

  38. I disagree that I’ve been condescending. I simply asked for your cites, and I pointed out that Dr. Scanlan knows his practice and patient-base better than a stranger. … If you read my blog you’ll see that I do not disagree that Suboxone helps people. It saved me. And my readers know that I think no one recovery approach works for everyone.

  39. Well I honestly have no clue what we’re disagreeing on here. I thought your tone initially was dismissive and patronizing, but if that’s not how you meant it, my apologies. I’m thrilled to know you agree that suboxone works. It saved my life as well. The patient’s I’ve been exposed to are hard core opiate addicts. I am a bit horrified to read that this doctor doesn’t believe in sub maintenance and detoxes with subs then sends people to exercise and NA meetings. However, he may be dealing with a patient base that is not as severely addicted and therefore his approach could work on those people.

  40. I’m not dismissive of Sub. My attitude toward Suboxone maintenance is shaped by my own drug-free recovery and by the many emails I receive from all over the country desperately asking for help quitting the drug and paralyzed by the depression and fatigue that set in when they try to stop. In many cases there is no incentive for Suboxone practitioners to get people off, and the prevailing attitude among doctors and in society is that opioid addicts are chronic relapsers who need drugs forever. That said, I agree with Scanlan that there exists a percentage of opioid addicts who need lifetime drug-treatment. (BTW, he doesn’t detox with Suboxone. As he says, he detoxes with Librium and other drugs. And exercise is an invaluable remedy for many conditions, including opioid withdrawal, depression, anxiety, etc. The literature is behind that.) … Thank you for reading and writing. It’s good to have a conversation.

  41. I thought you were dismissive towards me, not suboxone. I feel like everything I said has been twisted. This doctor has his beliefs. I know several doctors that believe the exact opposite of him and you. However, the patients we are dealing with are people that used heroin for 10-20 years. I have encountered no one that had any more difficulty detoxing from subs than from any other opiate. I still stand by whet I said. I disagree with his methods. He also stated that he believes subs are brilliant detox tools, but not as a maintenance drug. I think you and I come from very different places in our approach to treatment and that’s ok. But in my experience suboxone maintenance is the last resort for many.

  42. In your experience is there a difference in ability to recover with abstinence between heroin addicts and those addicted to Rx painkillers?

  43. Hi Guinevere,
    Just found your blog and read this article about Suboxone. I have been on it for almost 4 years. Desperate and scared to come off it. I also have heard of Ibogaine. I would be so grateful to be referred to some resources. Can you help me with that Please?
    Thank you
    Linda

  44. Thank GOD for Guinevere and Dr. Scanlan. I am at my third month at 16 mgs Pr. day. Six days ago down to 8 mg. Last day 4 in the morning and 4 at bedtime. I have spent hours and hours reading, calling and investigating this suppose to be wonder drug. I got addicted from one surgery after another to 23. Have to say that two-three minutes prior to going in the operating room – I LOVE THAT THERE FENT!!!! Wish I could have it without any problems of addiction. I called Addiction center in Tennessee and was told they get many people coming in to detox from Suboxone. Money is all that matters. Now after all my investigating I find out doctors can only treat 30 patients pr. year. Answers the effing reason why he wants me on it a year. Then I go to Manufacturers Web-site to find out to get the special DEA license to prescribe Suboxone the doctor must attend a whopping 8 hours of classroom study. Probably in Vegas studying with a partner in a hot tub. Then I keep reading and if a doctor doesn’t have the special DEA lic. and wants to prescribe he may if he tells them of his/her intention of attending in the future. People wake up please. My heart aches for you and I. Guinevere told me 3 months was the end of short term use. I went to my friend a trusted pharmacist that cares greatly for me. I said my nose won’t quit running, I am not sleeping more than 2 hours solid at a time and I am struggling to focus on work I must do. My fear with a very damaged colon is the withdrawal that includes severe diarrhea. I dehydrate when I start and then begin losing blood as well. Thank you Guinevere for this site. I am on my 3rd day without Subs. I told my pharmacist I had 5 zanex at home and it is a drug I never used on a regular basis but I need one good night sleep. I told him truthfully I had not had any subs since 6pm the prior evening. Almost 24 hours. I was nervous because of the severe warnings mixed with subs. DEATH That’s a good enough warning for me. He assured I would be ok – I slept 10 hours and feel like I have energy to battle. Almost through my 3rd day and waves of sweat come and leave just as quick. I have eaten well each day so far including today. I am done and am planning a walk later though I walk terribly from all the orthopedic surgeries. But hey I walk. What I am not gonna do is run with this poorly explained drug by doctors and a company whose major concern I assure you is profit. Give them your money – this man has better things to spend it on. And I am very spiritually involved. I pray for each and everyone of you. You own your life use what you need to to get through the worst then take your life back. Simply Black – Irate with this drug that makes so many rich that could care less where you or I end up.

  45. Kevin – seems like your doctor is a jerk. But I know me as an addict if I ran out it would because of me. Listen to Guinevere. You are probably not in the mood to hear this but you are not alone. I have cut down on my subs because my doc thinks a year @ 16 mg is a maintenance dose. After investigating starting with this site, then more sites and talking with others including detox centers that detox sub patients I am convinced that these doctors use this drug ignorantly or out of greed. Of course pharmaceutical company making 160 billion would probably lean towards the one year therapy. Docs can treat 30 patients for one year. HMMMM! Web-site for sub says not to prescribed for pain. I have pain so my addiction doc writes mine for pain. Opens up another slot for him eh? Friend I live alone, do a lot of reading, writing, having friends over or go out. None of my friends use and all miss me at church on Sundays missed. I described in detail and depth to my friends wife how bad my pain is, can hardly walk and I cry many nights at bed time and I assure I am a man and no sissy. I go to the doc’s tomorrow still have 8 films 8 mg and script ready from him I haven’t picked up. I just say to his questions, yeah, yeah, yes and ok see you next month. I hate subs period but living alone doesn’t make them worse. Staying alone does. I think @ 14 mg a day ( I am no expert ) just what I read isn’t gonna be to your liking out of your system in 13/14 days. If he left you like that go to the ER.

  46. Jenn – insurance issues are always a killer for addicts trying to get help. I don’t know but if you live within one thousand miles of Middle Point Ohio. Ridgeview Behavioral Hos. 419-968-2950. They pick you up and return you home 28 days later. Do not let them rule you. I told them subs ok but off before I leave. That didn’t happen but I think the doc saw a glimmer in my eyes when I said NO TRAZADONE – NO SERIQUEL – NO CYMBALTA. It was a gentle look I gave him like are you FUCKING CRAZY admit your FUCKING self. So in a sense I had control and involvement of my care. Hospital American Addiction Center said they have admitted people from Ridgeview for suboxone detox. But you need the help and they are caring just not knowledgeable about subs like many hosp. & docs. But no one can make you well but you – take what you need and leave the rest behind. Pour your heart to them, beg. cry, whatever it takes. Most importantly suck up – You heard from a friend that they are the greatest hospital in the world and you just want a chance to be the best mom you can be. If they ask who you heard from tell em you think his name was Shawn you had talked one evening at a meeting. PLEASE PLEASE I just can’t do it alone. I’ve been told they have broken before and helped a non-insured now and then. If they do you got gratitude starting 1st day. God Bless and look at all you have to live for. A child – you’ll feel the gift of that again – but first you got to feel the gift of JENN. Great Food, Loving care. Just Too much Suboxone they are just ignorant not stupid. Read Dr. Scanlan – Guinevere’s site has been a blessing and so much info. Simply Black & Strong

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