Ran four miles in the Rhode Island countryside this morning. No place in Rhode Island is very far from the coast and the light here is different from home, somehow both brighter and more gentle. Using it to paint:

Henry, age 2. Almost done.

More mail from a young guy in the Pacific Northwest:

I am battling with an addiction from Oxycodone. Approximately 15-60mg a day, and I had a few questions for you. My first question was, how hard and how long do you think I will withdraw for? I have been using for about 9 months, and just finished college and would like to get my life started. Second, I was wondering if you think it would be a bad idea for me to get about 2-3 8mg Suboxone pills, and cut them into quarters, use those for about a week, and get off them to help me skip the physical withdrawal symptoms. Please, respond as soon as you can as I am desperate for help.

Last week I attended a regional prescription drug abuse summit in my town. The U.S. Attorney’s office and the DEA and Obama’s drug-control policy people were there, and they made a big deal about two drugs: oxycodone and Opana—chemical name oxymorphone, metabolite of oxycodone. It’s twice as strong as oxycodone and is said to be three or to eight times stronger than morphine (though most sources cite oxycodone as being 1.5 times stronger than morphine, so these equivalencies don’t make sense). At any rate Opana is stronger than its parent drug.

Oxycodone is a short-acting drug—its half-life is 3-4 hours, which means within 24 hours it pretty much clears the system.

Suboxone, on the other hand, has a 37-hour half-life. Which means it takes days and days to clear the body.

First thing to consider: one milligram of suboxone is equivalent to 30mg morphine, or about 20mg oxycodone. The reader wants to “get” 8mg tablets and cut them into 2mg pieces, which would be upregulating the opioid receptors: he’d be taking the equivalent of 40mg oxycodone, but if he doses every 24 hours, he’d be stacking up the drug in his blood because it takes 37 hours for half a dose to clear the body.

Second, “getting” a prescription drug is problematic (criminal, a felony in my state, actually) unless it’s prescribed. Don’t buy on the street, OK, dude? … Number one, addicts are powerless over drugs. I couldn’t have trusted myself to “get” Suboxone and use it responsibly. Suboxone is a kickass substance and the only way I could have used it successfully for any purpose was under a reliable doctor’s hawkeye supervision.

My experience:

  1. A 60mg/day oxycodone habit is beatable through quitting cold-turkey or tapering. The acute withdrawal will involve about 10-14 days of sweating it out and feeling like you’ve got the flu; after that, maybe another month of feeling like life is a drag, but aerobic exercise can work wonders to cut down on insomnia, restless legs, etc. … I know 60mg feels like a huge amount. But hear this: I used Suboxone because I was on 100mcg fentanyl per hour, which is equivalent to about 400mg oxycodone per day. I don’t mean to minimize your experience, but using Suboxone for a 15-60mg/day habit is, to use my lay buprenorphine expert friend Jay’s analogy, like shooting an anthill with an atom bomb. … When I first took Suboxone I was tempted to stay on it for life because at first I felt so super-well, but that feeling changed within a matter of weeks. And I can’t tell you how many emails I’ve had and posts I’ve read from folks who used Suboxone to get off drugs and now can’t get off Suboxone. Your decision, of course, but just sharing experience.
  2. Log onto Opiate Detox Recovery and find others who have quit and are trying to quit short-acting painkillers. ODR has a wealth of reliable information and real-life experience and was an enormous support to me when I was trying to get sober.

One last piece of experience: face-to-face help is so important. Go to a meeting of people trying to quit drugs, any drugs—alcohol, painkillers, cocaine, whatever. Get phone numbers, call the people you meet, ask for help. It’s impossible to quit alone. To that end, I hope others will weigh in on all this.

The summer after graduating college is a great time to get sober and “get your life started.” Getting sober and starting your life are the same thing, and better to do it now than later. I’m in awe of folks who quit in their teens or 20s. You have your entire life ahead of you to find out who you are and be that, instead of using drugs to hide. If you ask for help, you will meet people who will tell you that you CAN do this. Let me be the first.

Thanks for helping me stay sober today.

Back to the palette.